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Construction Activity: An Independent Risk Factor for Invasive Aspergillosis and Zygomycosis in Patients with Hematologic Malignancy

Published online by Cambridge University Press:  02 January 2015

J. John Weems Jr.*
Affiliation:
Epidemiology Branch of the Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, and the Immunology Branch of the Division of Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Barry J. Davis
Affiliation:
Epidemiology Branch of the Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, and the Immunology Branch of the Division of Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Ofelia C. Tablan
Affiliation:
Epidemiology Branch of the Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, and the Immunology Branch of the Division of Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Leo Kaufman
Affiliation:
Epidemiology Branch of the Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, and the Immunology Branch of the Division of Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
William J. Martone
Affiliation:
Epidemiology Branch of the Hospital Infections Program, Center for Infectious Diseases, Centers for Disease Control, and the Immunology Branch of the Division of Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
*
Epidemiology Branch, Hospital Infections Program, Centers for Disease Control, Building 1, Room 5044, 1600 Clifton Road, Atlanta, GA30333

Abstract

Between November 1982 and July 1984, five patients at a 110-bed pediatric hospital were diagnosed with invasive filamentous fungal infection; three had invasive aspergillosis (IA) and two had invasive zygomycosis (IZ). All five had underlying hematologic malignancy (HM). In a case-control study, these five HM patients (cases) were compared to 10 autopsied HM patients without evidence of aspergillosis or zygomycosis (controls). Cases and controls did not differ in underlying disease or in the degree of immunosuppression, as measured by duration of granulocytopenia and number of platelet transfusions. However, case-patients were more likely than controls to have been hospitalized during the construction of a hospital addition (p<0.02, Fisher's exact test [FET]). Four (80%) of five HM patients autopsied during the period of construction had IA or IZ compared with one (5%) of 21 autopsied before construction began (p=0.001, FET). These findings suggest that, in a population of comparably immunosuppressed patients, construction activity may represent an independent risk factor for IA or IZ. Hospitals caring for such patients should take precautions which minimize exposure of these patients to construction or renovation activity.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

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