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1.
J Hosp Infect ; 106(1): 53-56, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32526255

RESUMO

High-efficiency particulate air supplied to a positive-pressure ventilation lobby (PPVL) in isolation rooms offers the dual advantage of protective and source isolation. This study demonstrates the in-use validity of PPVL rooms for protective isolation of patients. Of the 48 PPVL air samples investigated, Aspergillus fumigatus was detected from only one (2%) sample. Local and remote monitoring of the PPVL rooms is essential for the safety of patients and healthcare workers. Remote and point-of-use engineering controls are essential for ongoing ventilation monitoring, but this should be complemented by visual inspection of the isolation suite. Periodic microbiological monitoring should also be considered with other control measures.


Assuntos
Microbiologia do Ar , Infecção Hospitalar/prevenção & controle , Controle de Infecções/normas , Respiração com Pressão Positiva/normas , Aspergilose/prevenção & controle , Aspergilose/transmissão , Aspergillus fumigatus/patogenicidade , Ambiente Controlado , Pessoal de Saúde , Arquitetura Hospitalar , Humanos , Controle de Infecções/métodos , Isolamento de Pacientes/métodos , Isolamento de Pacientes/normas
2.
Emerg Infect Dis ; 25(4): 797-799, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30882308

RESUMO

We collected sputum samples and cough plates from 15 cystic fibrosis patients in the Netherlands who were colonized with Aspergillus fumigatus; we recovered A. fumigatus of the same genotype in cough aerosols and sputum samples from 2 patients. The belief that transmission of A. fumigatus from cystic fibrosis patients does not occur should be reconsidered.


Assuntos
Aspergilose/etiologia , Aspergilose/transmissão , Aspergillus fumigatus , Fibrose Cística/complicações , Exposição por Inalação/efeitos adversos , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Aspergilose/epidemiologia , Aspergillus fumigatus/classificação , Aspergillus fumigatus/efeitos dos fármacos , Aspergillus fumigatus/genética , Aspergillus fumigatus/isolamento & purificação , Fibrose Cística/epidemiologia , Genótipo , Humanos , Tipagem Molecular , Países Baixos/epidemiologia , Vigilância em Saúde Pública , Escarro/microbiologia
3.
Int J Food Microbiol ; 275: 1-7, 2018 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-29602047

RESUMO

Aspergillus fumigatus, the major etiological agent of human and animal aspergillosis, is a gliotoxinogenic species into section Fumigati commonly found in contaminated animal environments. In dairy herds, exposed areas of lactating cows, as mammalian glandule, can be easily contaminated by them. This study was aimed to identify A. fumigatus sensu lato strains (identified based on morphology) isolated from raw cow milk at species level, by morphological and molecular techniques, and to estimate their genetic variability. Forty-five A. fumigatus strains showed similar RAPD profiles (generated with PELF and URP1F primers) to each other and to A. fumigatus sensu stricto reference strains; also, they were almost identical to clinical human and feed-borne A. fumigatus strains included in the assay, since their similarity coefficient ranged from 0.7 to 1.00. Therefore, all strains were characterized as belonging to A. fumigatus sensu stricto species. This result was supported by sequencing the benA gene of selected strains and by maximum parsimony analysis. In addition, RAPD fingerprinting demonstrated intra-specific genetic variability into the A. fumigatus sensu stricto cluster. The results found in this study strengthen the fact that A. fumigatus sensu stricto is the predominant species in the Aspergillus section Fumigati found in animal environments such as dairy herd environments, while other species such as A. novofumigatus, A. fumigatiaffinis, A. udagawae and A. lentulus may be rarely isolated. Since no differences between animal and human strains were observed they can become pathogenic also for farm handlers'. Moreover, the presence of A. fumigatus sensu stricto in raw cow milk is probably a very important risk factor since milk and its by-products are generally indented for human consumption, then gliotoxin could be transferred to them.


Assuntos
Aspergillus fumigatus , Glândulas Mamárias Animais/microbiologia , Leite/microbiologia , Animais , Argentina , Aspergilose/microbiologia , Aspergilose/transmissão , Aspergillus fumigatus/classificação , Aspergillus fumigatus/genética , Aspergillus fumigatus/isolamento & purificação , Bovinos , Impressões Digitais de DNA , Feminino , Contaminação de Alimentos/análise , Microbiologia de Alimentos , Variação Genética/genética , Humanos , Lactação , Tipagem Molecular , Técnica de Amplificação ao Acaso de DNA Polimórfico
5.
Mycopathologia ; 181(3-4): 175-84, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26582086

RESUMO

Aspergillus flavus is the most common species associated with invasive aspergillosis in Tunisia. The molecular epidemiology of the species is poorly documented. We used five highly discriminative microsatellite markers for the genotyping of clinical and hospital environmental A. flavus strains to assess whether IA could be hospital-acquired in the onco-hematology unit of the Farhat Hached teaching hospital of Sousse, Tunisia. The genotyping of 18 clinical isolates, collected from sputa of 17 acute leukemia patients, and 81 isolates, collected in these patients' hospital environment and food, identified 57 isolates that were grouped in 10 clones, each of them including 2-17 isolates. The remaining 42 isolates showed a unique genotype. Two main transmission scenarios were observed: (1) the same clone was isolated from different patients; (2) the same clone was isolated from a patient, its hospital environment and/or food. These findings strongly suggest the occurrence of hospital-acquired A. flavus infection/colonization in the investigated onco-hematology unit.


Assuntos
Aspergilose/epidemiologia , Aspergillus flavus/genética , Infecção Hospitalar/microbiologia , Repetições de Microssatélites/genética , Tipagem Molecular/métodos , Aspergilose/microbiologia , Aspergilose/transmissão , Aspergillus flavus/isolamento & purificação , Sequência de Bases , Genótipo , Unidades Hospitalares , Humanos , Epidemiologia Molecular , Análise de Sequência de DNA , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Tunísia/epidemiologia
6.
Intern Med J ; 44(12b): 1389-97, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25482747

RESUMO

Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted.


Assuntos
Microbiologia do Ar , Aspergilose/prevenção & controle , Aspergillus/crescimento & desenvolvimento , Infecção Hospitalar/prevenção & controle , Exposição Ambiental/prevenção & controle , Arquitetura Hospitalar/normas , Antifúngicos , Aspergilose/transmissão , Lista de Checagem , Consenso , Infecção Hospitalar/microbiologia , Ambiente Controlado , Filtração/instrumentação , Guias como Assunto , Humanos , Hospedeiro Imunocomprometido , Controle de Infecções , Educação de Pacientes como Assunto
7.
J Med Microbiol ; 63(Pt 3): 464-470, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24430250

RESUMO

Data on the occurrence and epidemiology of Aspergillus spp. in laying hens farms are scant. With the aims of determining levels of airborne contamination in laying hen farms and evaluating the potential risk of infection for workers and animals, 57 air samples from 19 sheds (Group I), 69 from faeces (Group II), 19 from poultry feedstuffs (Group III) and 60 from three anatomical sites (i.e. nostrils, pharynx, ears) of 20 farm workers (Group IV) were cultured. The Aspergillus spp. prevalence in samples ranged from 31.6% (Group III) to 55.5% (Group IV), whereas the highest conidia concentration was retrieved in Group II (1.2 × 10(4) c.f.u. g(-1)) and in Group III (1.9 × 10(3) c.f.u. g(-1)). The mean concentration of airborne Aspergillus spp. conidia was 70 c.f.u. m(-3) with Aspergillus fumigatus (27.3%) being the most frequently detected species, followed by Aspergillus flavus (6.3%). These Aspergillus spp. were also isolated from human nostrils (40%) and ears (35%) (P<0.05) (Group IV). No clinical aspergillosis was diagnosed in hens. The results demonstrate a relationship between the environmental contamination in hen farms and presence of Aspergillus spp. on animals and humans. Even if the concentration of airborne Aspergillus spp. conidia (i.e. 70 c.f.u. m(-3)) herein detected does not trigger clinical disease in hens, it causes human colonization. Correct management of hen farms is necessary to control environmental contamination by Aspergillus spp., and could lead to a significant reduction of animal and human colonization.


Assuntos
Doenças dos Trabalhadores Agrícolas/epidemiologia , Microbiologia do Ar , Aspergilose/epidemiologia , Aspergillus/isolamento & purificação , Galinhas/microbiologia , Doenças das Aves Domésticas/epidemiologia , Doenças dos Trabalhadores Agrícolas/microbiologia , Criação de Animais Domésticos , Animais , Aspergilose/microbiologia , Aspergilose/transmissão , Aspergillus/genética , Aspergillus flavus/genética , Aspergillus flavus/isolamento & purificação , Aspergillus fumigatus/genética , Aspergillus fumigatus/isolamento & purificação , Sequência de Bases , Microbiologia Ambiental , Fezes/microbiologia , Feminino , Abrigo para Animais , Humanos , Itália/epidemiologia , Dados de Sequência Molecular , Doenças das Aves Domésticas/microbiologia , Doenças das Aves Domésticas/transmissão , Prevalência , Análise de Sequência de DNA , Esporos Fúngicos
8.
J Am Assoc Lab Anim Sci ; 52(5): 541-4, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24041208

RESUMO

Aspergillus fumigatus causes life-threatening pneumonia in immunocompromised patients. Conidia, the infectious form of the organism, are handled in a biologic safety cabinet under BSL2 conditions. However because germinated conidia form noninfectious hyphae in tissue, we hypothesized that rabbits inoculated intratracheally would grow A. fumigatus in their lungs but that the environment would remain free of this fungus, potentially permitting maintenance of infected animals under ABSL1 conditions. We performed a surveillance study for the presence of A. fumigatus in the environment before proceeding with antifungal therapy studies of experimental pulmonary aspergillosis. The expected outcome included absence of A. fumigatus in the environment, stool, and blood and presence in rabbit lungs. Female SPF New Zealand white rabbits were immunosuppressed and inoculated intratracheally (n = 4) or intraesophageally (n = 2) with 1.25 × 10(8) conidia of A. fumigatus. Feces, pan liners, and walls were sampled daily during the 11-d experiment, and blood was sampled on days 2, 6, and 8 after inoculation. Samples were cultured on 5% Sabouraud glucose agar plates. Lungs were weighed and scored for hemorrhagic infarcts and homogenized for culture on 5% Sabouraud glucose agar and trypticase soy agar plates. Blood cultures, rabbit stool, and environmental swabs were all negative for A. fumigatus whereas the lungs inoculated intratracheally demonstrated 4.5 × 10(2) ± 0.8 × 10(2) CFU/g of A. fumigatus. Therefore, neutropenic rabbits with experimental invasive pulmonary aspergillosis do not shed conidia of A. fumigatus and can be safely housed under ABSL1 conditions after inoculation.


Assuntos
Aspergilose/imunologia , Aspergillus fumigatus/isolamento & purificação , Modelos Animais de Doenças , Monitoramento Ambiental/métodos , Aspergilose Pulmonar/imunologia , Coelhos , Animais , Aspergilose/transmissão , Citarabina/farmacologia , Feminino , Abrigo para Animais , Humanos , Imunossupressores/farmacologia , Pulmão/microbiologia , Metilprednisolona/farmacologia , Neutropenia/imunologia , Neutropenia/microbiologia , Aspergilose Pulmonar/transmissão
9.
Risk Anal ; 33(8): 1441-53, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23311627

RESUMO

Invasive aspergillosis (IA) is a major cause of mortality in immunocompromized hosts, most often consecutive to the inhalation of spores of Aspergillus. However, the relationship between Aspergillus concentration in the air and probability of IA is not quantitatively known. In this study, this relationship was examined in a murine model of IA. Immunosuppressed Balb/c mice were exposed for 60 minutes at day 0 to an aerosol of A. fumigatus spores (Af293 strain). At day 10, IA was assessed in mice by quantitative culture of the lungs and galactomannan dosage. Fifteen separate nebulizations with varying spore concentrations were performed. Rates of IA ranged from 0% to 100% according to spore concentrations. The dose-response relationship between probability of infection and spore exposure was approximated using the exponential model and the more flexible beta-Poisson model. Prior distributions of the parameters of the models were proposed then updated with data in a Bayesian framework. Both models yielded close median dose-responses of the posterior distributions for the main parameter of the model, but with different dispersions, either when the exposure dose was the concentration in the nebulized suspension or was the estimated quantity of spores inhaled by a mouse during the experiment. The median quantity of inhaled spores that infected 50% of mice was estimated at 1.8 × 10(4) and 3.2 × 10(4) viable spores in the exponential and beta-Poisson models, respectively. This study provides dose-response parameters for quantitative assessment of the relationship between airborne exposure to the reference A. fumigatus strain and probability of IA in immunocompromized hosts.


Assuntos
Aspergilose/microbiologia , Aspergilose/transmissão , Aspergillus fumigatus/metabolismo , Algoritmos , Animais , Teorema de Bayes , Feminino , Hospedeiro Imunocomprometido , Pulmão/microbiologia , Camundongos , Camundongos Endogâmicos BALB C , Modelos Estatísticos , Distribuição de Poisson , Probabilidade , Medição de Risco , Esporos Fúngicos/metabolismo , Fatores de Tempo
10.
Enferm Infecc Microbiol Clin ; 30(10): 645-53, 2012 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-23127517

RESUMO

Invasive fungal infections (IFI) represent a serious threat for patients undergoing solid organ transplantation (SOT). IFI in SOT has a significant incidence and mortality not due to negligence. The management of IFI in SOT involves specific recommendations and has been individualized to the type of transplant and patient. The current review presents an overview of epidemiology, diagnosis, treatment and prevention of IFI in TOS. Depending on risk factors for different IFIs and transplant type, this paper includes the main recommendations based on previous publications and on the opinion of the authors on the prophylaxis and treatment of these patients. These recommendations highlight epidemiology changes and the emergence of new antifungals. The current document has focused mainly on Candidaspp. and Aspergillusspp., with a special mention to the rest of yeasts and moulds that are common in SOT.


Assuntos
Fungemia/etiologia , Transplante de Órgãos , Complicações Pós-Operatórias/etiologia , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Aspergilose/diagnóstico , Aspergilose/tratamento farmacológico , Aspergilose/epidemiologia , Aspergilose/etiologia , Aspergilose/prevenção & controle , Aspergilose/transmissão , Candidíase Invasiva/diagnóstico , Candidíase Invasiva/tratamento farmacológico , Candidíase Invasiva/epidemiologia , Candidíase Invasiva/etiologia , Candidíase Invasiva/prevenção & controle , Candidíase Invasiva/transmissão , Estudos de Coortes , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Infecção Hospitalar/prevenção & controle , Criptococose/diagnóstico , Criptococose/tratamento farmacológico , Criptococose/epidemiologia , Criptococose/etiologia , Criptococose/prevenção & controle , Criptococose/transmissão , Interações Medicamentosas , Fungemia/diagnóstico , Fungemia/tratamento farmacológico , Fungemia/epidemiologia , Fungemia/prevenção & controle , Fungemia/transmissão , Humanos , Hospedeiro Imunocomprometido , Incidência , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/tratamento farmacológico , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/etiologia , Infecções Oportunistas/prevenção & controle , Transplante de Órgãos/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Guias de Prática Clínica como Assunto , Pré-Medicação , Risco
11.
Can Vet J ; 53(2): 190-2, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22851783

RESUMO

An intact bitch with a history of mating was presented with severe lameness and a vulvar discharge. A mixed lytic, proliferative tibial lesion and open pyometra were diagnosed. Bone biopsy and uterine culture revealed disseminated aspergillosis. This is the first report of Aspergillus pyometra with dissemination following mating in the dog.


Assuntos
Aspergilose/veterinária , Doenças do Cão/diagnóstico , Piometra/veterinária , Animais , Antifúngicos/uso terapêutico , Aspergilose/diagnóstico , Aspergilose/tratamento farmacológico , Aspergilose/transmissão , Copulação , Doenças do Cão/tratamento farmacológico , Doenças do Cão/transmissão , Cães , Evolução Fatal , Feminino , Fluconazol/uso terapêutico , Itraconazol/uso terapêutico , Masculino , Piometra/diagnóstico , Piometra/tratamento farmacológico , Piometra/etiologia
12.
Am J Infect Control ; 40(5): 465-7, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21885159

RESUMO

After having eliminated a dysfunction of the hospital's ventilation system and any other possible environmental reservoir, the investigation of a fatal case of primary cutaneous aspergillosis in a neonate with extremely low birth weight led to the conclusion that nonsterile disposable gloves kept stored in their native packages were the likely source of contamination.


Assuntos
Aspergilose/diagnóstico , Aspergilose/transmissão , Dermatomicoses/diagnóstico , Dermatomicoses/transmissão , Luvas Cirúrgicas/microbiologia , Aspergilose/patologia , Dermatomicoses/patologia , Evolução Fatal , Humanos , Recém-Nascido
13.
Med Mycol ; 50(1): 91-8, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21756021

RESUMO

Aspergillosis remains a major cause of infection-related avian mortality in birds that are debilitated and undergoing rehabilitation for release into the wild. This study was designed to understand the source of avian aspergillosis in seabirds undergoing rehabilitation at selected northern California aquatic bird rehabilitation centers. Air, surface and water sampling was performed between August 2007 and July 2008 in three such centers and selected natural seabird loafing sites. Average air Aspergillus fumigatus counts were at least nine times higher in samples obtained from the rehabilitation sites (M = 7.34, SD = 9.78 CFU/m(3)), when compared to those found at natural sites (M = 0.76, SD = 2.24 CFU/m(3)), t (205) = -5.99, P < 0.001. A total of 37 A. fumigatus isolates from birds with confirmed aspergillosis and 42 isolates from environmental samples were identified using both morphological and molecular methods, and subsequently sub-typed using an eight-locus microsatellite panel with the neighbor joining algorithm. Results of the study demonstrated the presence of five clonal groups, 13 genotypically related clusters, and 59 distinct genotypes. Six of the 13 genotypically related clusters contained matching genotypes between clinical isolates and local environmental isolates from the rehabilitation center in which these birds were housed. We present evidence that the environment of rehabilitation centers may be a source for A. fumigatus infection in rehabilitated seabirds.


Assuntos
Aspergilose/microbiologia , Aspergilose/veterinária , Aspergillus fumigatus/classificação , Aspergillus fumigatus/isolamento & purificação , Doenças das Aves/epidemiologia , Doenças das Aves/microbiologia , Animais , Aspergilose/epidemiologia , Aspergilose/transmissão , Doenças das Aves/transmissão , Aves , California , Análise por Conglomerados , DNA Fúngico/genética , Microbiologia Ambiental , Genótipo , Repetições de Microssatélites , Epidemiologia Molecular , Tipagem Molecular , Técnicas de Tipagem Micológica , Centros de Reabilitação
14.
Clin Microbiol Infect ; 17(9): 1387-90, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21745256

RESUMO

The daily number of outdoor spores was counted and the cases of community-acquired invasive aspergillosis (IA) were observed over a period of 31 months. The outdoor fungal load preceding IA occurrences was significantly higher than that measured during IA-free periods, underlining the importance of preventive measures to protect high-risk patients, even at home.


Assuntos
Microbiologia do Ar , Aspergilose/microbiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , Aspergilose/transmissão , Contagem de Colônia Microbiana , Infecções Comunitárias Adquiridas/transmissão , Infecção Hospitalar/transmissão , Humanos , Incidência , Estudos Prospectivos , Esporos Fúngicos
15.
Med Mycol ; 49 Suppl 1: S24-9, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20818924

RESUMO

Discrimination between nosocomial and community infections is important for investigation and prevention. Nosocomial and hospital-acquired infections require appropriate hospital control measures to avert additional cases. Nosocomial infections (NI) occur during hospitalization or are caused by microorganisms acquired during hospital stay. Such infections should not be evident when patients are admitted to the hospital. Furthermore, the definition of NI is based on epidemiological criteria, such as the time lapse between admission and onset, or microbiological criteria. This definition might be difficult to apply to invasive aspergillosis (IA) which often afflicts patients with severe immunosuppression or transplantation. Identification of the source may be difficult which could arise outside or inside the hospital. Another significant issue is the lack of valid and reproducible data on the incubation period. The incubation duration of IA is influenced by different individual or environmental determinants, including the severity of immunosuppression and air quality. The criteria of causality are also a means of discussing the contribution of hospital vs. community determinants of IA. The definition of nosocomial IA remains difficult. A better understanding of early events related to IA onset will help to prevent this disease for which the prognosis remains negative.


Assuntos
Aspergilose/transmissão , Aspergillus/patogenicidade , Infecções Comunitárias Adquiridas/transmissão , Infecção Hospitalar/transmissão , Aspergilose/epidemiologia , Aspergilose/microbiologia , Causalidade , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Reservatórios de Doenças , Hospitalização , Humanos , Incidência , Período de Incubação de Doenças Infecciosas , Tempo de Internação
16.
J Infect Chemother ; 16(6): 431-5, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20981562

RESUMO

Hospital renovation projects pose risks of invasive infection by fungi from dust that is blown about during the period in question. Control measures to reduce the amount of dust during hospital renovation are thus necessary. Currently, no study has compared different control measures for effectiveness through more than one period of renovation. In this study, we examined the capacities of two control measures of weatherstripping (0.15 mm poly film and adhesive tape) to reduce the amount of blowing dust during two different hospital renovations (in 2008 and 2009). The amount of dust in the air of the hospital before and during the renovation was measured about once a week in both 2008 and 2009, and the between-year and within-year differences were tested. Our study revealed that the weatherstripping used in 2009 (adhesive tape) was significantly more effective than the measures taken in 2008 (0.15 mm poly film) to reduce the amount of dust during the renovations (p < 0.001), while in both years the amount of dust became significantly higher during the renovations than before the renovations. Differences in the effectiveness of weatherstripping during renovations between floors of the hospital were not significant in both 2008 and 2009. The number of Aspergillus-positive samples did not significantly increase compared with the number observed before the start of the hospital renovations (2006-2007) in 2008 and 2009, respectively. The weatherstripping potentially reduced the associated risk of airborne fungal infection.


Assuntos
Adesivos , Microbiologia do Ar , Poeira/análise , Fungos/isolamento & purificação , Arquitetura Hospitalar/métodos , Controle de Infecções/métodos , Micoses/prevenção & controle , Poluição do Ar em Ambientes Fechados/análise , Aspergilose/prevenção & controle , Aspergilose/transmissão , Aspergillus/isolamento & purificação , Materiais de Construção , Hospitais Universitários , Humanos , Micoses/transmissão , Esporos Fúngicos/isolamento & purificação
17.
Transpl Infect Dis ; 12(1): 54-9, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19804583

RESUMO

The growing need for organs and the scarcity of donors has resulted in an increased use of extended criteria donors. We report a case where a recipient of a cardiac graft was used as an organ donor. Death of the recipient occurred 9 days after transplantation and was attributed to presumed cerebral hemorrhage, which post mortem was diagnosed as invasive aspergillosis of the brain. One recipient of a kidney transplant lost the graft due to infection with Aspergillus fumigatus, whereas prompt initiation of therapy successfully prevented disseminated aspergillosis in the other recipients. Despite the pressure to extend the use of organs by lowering the acceptance criteria, organs should only be accepted if the cause of death of the donors is unequivocally explained.


Assuntos
Aspergilose/transmissão , Aspergillus fumigatus/isolamento & purificação , Transplante das Ilhotas Pancreáticas/efeitos adversos , Transplante de Órgãos/efeitos adversos , Doadores de Tecidos , Adulto , Idoso , Aspergilose/diagnóstico , Aspergilose/microbiologia , Feminino , Humanos , Transplante de Rim/efeitos adversos , Transplante de Fígado/efeitos adversos , Transplante de Pulmão/efeitos adversos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
18.
Pathol Biol (Paris) ; 57(1): 71-5, 2009 Feb.
Artigo em Francês | MEDLINE | ID: mdl-19157722

RESUMO

Invasive hospital-acquired aspergillosis (IA) is responsible for lethal outbreaks. In 2002, an interdisciplinary team was created in the teaching hospital of Rouen in order to organize the surveillance of construction sites by the implementation of environmental measures of prevention. The aim of our study was to estimate the efficiency of these measures using an indirect indicator, reflecting the incidence of the cases of invasive nosocomial aspergillosis (AI): the consumption of antifungals. From the nominative prescriptions established, we studied the medical files about 210 patients to track down the number of IA cases in intensive care unit (ICUI) and in pediatric hematology-oncology units between 2002 and 2006. The incidence of the cases was put in parallel with the various periods of level 5-risk works during these five years. The relative risk of appearance of the disease was calculated. In pediatric haematology-oncology unit, 35 cases were diagnosed on 99 medical files which have been studied and in ICU 19 cases were classified on 93 studied files. The follow-up of the incidence in both units stake in parallel with the periods of level 5-risk works does not show increase of the number of cases. The calculated relative risk indicates the same result: the level 5-risk works are not a factor facilitating the appearance of invasive aspergillosis cases. This study shows the importance of the environmental measures of prevention during the periods of works within services for risk. The coordination of the actors within an interdisciplinary cell seems thus essential for the prevention of AIN.


Assuntos
Poluição do Ar em Ambientes Fechados/prevenção & controle , Aspergilose/prevenção & controle , Infecção Hospitalar/prevenção & controle , Desinfecção/métodos , Ambiente Controlado , Exposição Ambiental/prevenção & controle , Arquitetura Hospitalar , Comunicação Interdisciplinar , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/epidemiologia , Aspergilose/transmissão , Criança , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/transmissão , Prescrições de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Filtração/instrumentação , França/epidemiologia , Hematologia , Departamentos Hospitalares/estatística & dados numéricos , Arquitetura Hospitalar/normas , Hospitais Universitários/organização & administração , Humanos , Incidência , Unidades de Terapia Intensiva/estatística & dados numéricos , Oncologia , Prontuários Médicos , Pessoa de Meia-Idade , Pediatria , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Esporos Fúngicos
20.
Rev Prat ; 58(9): 933-8, 2008 May 15.
Artigo em Francês | MEDLINE | ID: mdl-18672656

RESUMO

Aspergillosis, due to moulds belonging to the genus Aspergillus, occurs in patients with residual lung cavities. The clinical manifestations are determined by the host immune response, ranging from a local inflammatory response to the systemic dissemination. Haemoptysis is the most common symptom. The chest X-ray reveals a round mass with a radio-lucent crescent of air. The antifungal treatments are successful.


Assuntos
Aspergilose/diagnóstico , Aspergilose/tratamento farmacológico , Antifúngicos/uso terapêutico , Aspergilose/transmissão , Humanos , Pulmão/diagnóstico por imagem , Radiografia , Fatores de Risco
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