Monitoring of clinical strains and environmental fungal aerocontamination to prevent invasive aspergillosis infections in hospital during large deconstruction work: a protocol study.
INTRODUCTION
Monitoring fungal aerocontamination is an essential measure to prevent severe invasive aspergillosis (IA) infections in hospitals. One central block among 32 blocks of Edouard Herriot Hospital (EHH) was entirely demolished in 2015, while care activities continued in surrounding blocks. The main objective was to undertake broad environmental monitoring and clinical surveillance of IA cases to document fungal dispersion during major deconstruction work and to assess clinical risk.


METHODS AND ANALYSIS
A daily environmental survey of fungal loads was conducted in eight wards located near the demolition site. Air was collected inside and outside selected wards by agar impact samplers. Daily spore concentrations were monitored continuously by volumetric samplers at a flow rate of 10 L.min-1. Daily temperature, wind direction and speed as well as relative humidity were recorded by the French meteorological station Meteociel. Aspergillus fumigatus strains stored will be genotyped by multiple-locus, variable-number, tandem-repeat analysis. Antifungal susceptibility will be assessed by E-test strips on Roswell Park Memorial Institute medium supplemented with agar. Ascertaining the adequacy of current environmental monitoring techniques in hospital is of growing importance, considering the rising impact of fungal infections and of curative antifungal costs. The present study could improve the daily management of IA risk during major deconstruction work and generate new data to ameliorate and redefine current guidelines.


ETHICS AND DISSEMINATION
This study was approved by the clinical research and ethics committees of EHH.
['Loeffert|Sophie Tiphaine|ST|', 'Melloul|Elise|E|', 'Dananché|Cédric|C|', 'Hénaff|Laetitia|L|', 'Bénet|Thomas|T|', 'Cassier|Pierre|P|', 'Dupont|Damien|D|', 'Guillot|Jacques|J|', 'Botterel|Françoise|F|', 'Wallon|Martine|M|', 'Gustin|Marie-Paule|MP|', 'Vanhems|Philippe|P|']
D000391:Air Microbiology D000935:Antifungal Agents D001228:Aspergillosis D001232:Aspergillus fumigatus D003428:Cross Infection D025141:Drug Resistance, Fungal D004784:Environmental Monitoring D005160:Facility Design and Construction D005602:France D005838:Genotype D006761:Hospitals D006801:Humans D017053:Infection Control D008826:Microbial Sensitivity Tests D011446:Prospective Studies
invasive aspergillosis environmental monitoring aspergillus fumigatus azole resistance clinical monitoring genetic patterns