Sampling and analysis of air for Aspergillus
Nosocomial (i.e. hospital acquired) outbreaks of aspergillosis have become a well-recognised complication of construction, demolition or renovation work in or near hospital wards in which immunosuppressed patients are located.
What is Aspergillus?
Aspergillus is a fungus or fungal mould whose spores are present in the air we breathe, but does not normally cause illness. However an individual with a weakened immune status may be susceptible to aspergillus infection for which there is a high mortality rate.
Aspergillosis is a group of diseases which can result from aspergillus infection which may affect patients whose immune system may be compromised – including those with leukaemia, chemotherapy patients or those on steroids, transplant patients, cystic fibrosis, HIV or AIDS, chronic obstructive pulmonary disease (COPD), chronic granulomatous disease (CGD), severe asthma with fungal sensitivity (SAFS) and many others.
The risk factors
Sources of increased risk include dirty air conditioning units, compost heaps and damp or flood-damaged housing, all of which can yield higher numbers of aspergillus spores.
Prevention of transmission of Aspergillus Spores
It is essential to maintain air-handling systems in HDU/ICU and other high-risk patient-care areas according to the published recommendations.
The guidelines also require you to develop a water-damage response plan for immediate execution when water leaks, spills, and moisture accumulation occur to prevent fungal growth in the areas where immunocompromised patients are located; as well as implementing specialist procedures for daily cleaning and routine maintenance, to ensure that spores are not spread.
These guidelines also focus on the protection of patients during high risk periods such as construction/renovation of hospitals. During construction, the dust generated must be minimised and the adjacent patient areas must be protected against the dust. Guidelines call for the systematic review and coordination of infection-control strategies with personnel in charge of the facility’s engineering, maintenance, central supply and distribution, and catering services.
Specifically when planning construction, demolition, and renovation activities in and around the facility, assess whether patients at high-risk for aspergillosis are likely to be exposed to high ambient-air spore counts of Aspergillus spp. from sites, and if so, undertake a risk assessment and develop a plan to prevent such exposures.
Specialist Sampling Services
HBE provide the following service based on the National Disease Surveillance Centre “National Guidelines for the Prevention of Nosocomial Invasive Aspergillosis During Construction/Renovation Activities” (Download a PDF copy):
- Provision of technical competent personnel to visit site with an air sampler and Agar plates
- Sample areas as specified
- Send the plates to the laboratory for incubation and enumeration
- Present the report electronically or via our compliance management system, HBE manager
- Site visits are determined by the client and can be either planned in advance for the time frame of the project or as one off site visits
Materials and equipment:
- Sampling Instrument: Surface Air Systems microbiological air sampler as specified in NDSC guidance
- Medium: Czapek Dox Agar as specified in NDSC guidance
For more information about Aspergillus, call your local HBE office or email email@example.com
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