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Efficacy of Prevention by High-Efficiency Particulate Air Filtration or Laminar Airflow Against Aspergillus Airborne Contamination During Hospital Renovation

Published online by Cambridge University Press:  02 January 2015

Muriel Cornet ,
Vincent Levy ,
Laurent Fleury ,
Jacques Lortholary ,
Sandrine Barquins ,
Marie-Hélène Coureul ,
Elisabeth Deliere ,
Robert Zittoun ,
Gilles Brücker  and
Anne Bouvet
Muriel Cornet*
Affiliation:
Service de Microbiologie, Comité de Lutte contre les Infections Nosocomiales, Hôpital Hôtel-Dieu, Paris, France Service Vigilance Hygiène et Prévention, Direction de la Politique Médicale, Assistance Publique-Hôpitaux de paris, Paris, France
Vincent Levy
Affiliation:
Service d'Hématologie, Hôpital Hô-Dieu, Paris, France
Laurent Fleury
Affiliation:
Service Vigilance Hygiène et Prévention, Direction de la Politique Médicale, Assistance Publique-Hôpitaux de paris, Paris, France
Jacques Lortholary
Affiliation:
Service Vigilance Hygiène et Prévention, Direction de la Politique Médicale, Assistance Publique-Hôpitaux de paris, Paris, France
Sandrine Barquins
Affiliation:
Service de Microbiologie, Comité de Lutte contre les Infections Nosocomiales, Hôpital Hôtel-Dieu, Paris, France
Marie-Hélène Coureul
Affiliation:
Service de Microbiologie, Comité de Lutte contre les Infections Nosocomiales, Hôpital Hôtel-Dieu, Paris, France
Elisabeth Deliere
Affiliation:
Service de Microbiologie, Comité de Lutte contre les Infections Nosocomiales, Hôpital Hôtel-Dieu, Paris, France
Robert Zittoun
Affiliation:
Service d'Hématologie, Hôpital Hô-Dieu, Paris, France
Gilles Brücker
Affiliation:
Service Vigilance Hygiène et Prévention, Direction de la Politique Médicale, Assistance Publique-Hôpitaux de paris, Paris, France
Anne Bouvet
Affiliation:
Service de Microbiologie, Comité de Lutte contre les Infections Nosocomiales, Hôpital Hôtel-Dieu, Paris, France
*
Service de microbiologie, Hôtel-Dieu, 1, Place du Parvis Notre-Dame, 75181 Paris Cedex 04, France
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Abstract

Objective:

To evaluate efficacy of laminar airflow facilities plus high-efficiency particulate air (HEPA) filtration and HEPA filtration alone in preventing environmental Aspergillus contamination during hospital renovation. To show the usefulness of environmental surveillance to facilitate protection of patients at risk for invasive pulmonary aspergillosis.

Design:

Prospective sampling of air and surfaces for Aspergillus conidia during 2-year period.

Setting:

A hematological department adjacent to building renovation at a university hospital.

Results:

1,047 air samples and 1,178 surface samples were collected from January 1996 to December 1997. Significantly more air samples were positive for Aspergillus species during the period of building renovation than during the periods before and after renovation in a unit without a protected air supply adjacent to the building work area (51.5% vs 31.7%; odds ratio [OR], 2.3; 95% confidence interval [CI95, 1.4-3.7; P<.001). A major increase in the frequency of positive air samples was also found in another adjacent unit that was protected with HEPA filtration alone (from 1.8% to 47.5%; OR, 48.9; CI95,12-229; P<10-7). In addition, in this unit, the mean count of Aspergillus conidia in positive air samples increased significantly during construction (4 colony-forming units [CFU]/m3 to 24.7 CFU/m3; P=.04) and the proportion of positive surface samples showed a significant increase during renovation (from 0.4% to 9.7%; OR, 28.3; CI95, 3.4-623; P=104). However, none of 142 air samples collected during renovation in the area protected with laminar airflow plus HEPA filtration showed Aspergillus conidia. In a unit distant from the building renovation site, the results of air and surface samples were not affected by renovation.

Conclusion:

This study showed a strong association between building renovation and an increase in environmental Aspergillus contamination. Results confirmed the high efficacy of laminar airflow plus HEPA filtration and a high air-change rate. Although filtration with HEPA was effective during normal conditions, it alone was unable to prevent the rise of Aspergillus contamination related to building renovation. This study emphasized the necessity of an environmental survey of airborne contamination related to construction, to facilitate prevention of nosocomial aspergillosis outbreaks. A standardized protocol for aerobiological surveillance is needed.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 7 , July 1999 , pp. 508 - 513
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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