Outbreak of Invasive Aspergillus Infection in Surgical Patients, Associated with a Contaminated Air-Handling System

An outbreak of Aspergillus infection at a tertiary care hospital was identified among inpatients who had amputation wounds, peritonitis, allograft nephritis, or mediastinitis. During a 2-year period, 6 patients were identified, all of whom had Aspergillus species recovered from samples from normally...

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Bibliographic Details
Published in:Clinical infectious diseases 2003-09, Vol.37 (6), p.786-793
Main Authors: Lutz, Brock D., Jin, Jiankang, Rinaldi, Michael G., Wickes, Brian L., Huycke, Mark M.
Format: Article
Language:English
Subjects:
Abdomen
Air Conditioning
Air Microbiology
Air Pollution, Indoor
Aspergillosis
Aspergillosis - epidemiology
Aspergillus
Aspergillus - genetics
Aspergillus - isolation & purification
Aspergillus fumigatus
Biological and medical sciences
Conidia
Cross Infection - epidemiology
Disease Outbreaks
DNA, Fungal - analysis
Female
Fungal infections
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Infections
Insulation
Invasive species
Major Articles
Medical sciences
Middle Aged
Operating rooms
Other diseases. Semiology
Ventilation
Wound infections
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Summary:An outbreak of Aspergillus infection at a tertiary care hospital was identified among inpatients who had amputation wounds, peritonitis, allograft nephritis, or mediastinitis. During a 2-year period, 6 patients were identified, all of whom had Aspergillus species recovered from samples from normally sterile sites. All cases clustered in the operating theater during a single 12-day period. To assess operating theater air quality, particle counts were measured as surrogate markers for Aspergillus conidia. A substantial increase in the proportion of airborne particles ⩾3 µm in size (range, 3-fold to 1000-fold) was observed in many operating rooms. A confined space video camera identified moisture and contamination of insulating material in ductwork and variable airflow volume units downstream of final filters. No additional invasive Aspergillus wound infections were identified after the operating theater air-handling systems were remediated, suggesting that this unusual outbreak was due to the deterioration of insulating material in variable airflow volume units.
ISSN:1058-4838
1537-6591
DOI:10.1086/377537