Monitoring environmental Aspergillus spp. contamination and meteorological factors in a haematological unit

Parasitological and microbiological assessment of contact lens storage cases: a survey of asymptomatic lens student wearers from five medical specialties in Tunisia, North Africa

BACKGROUND

Contamination of contact lenses has always been correlated with contamination of lenses and lens storage cases (LSCs), with higher loads of microorganisms in LSCs. The aim of the present study is to better understand non-compliance with strict hygiene rules in asymptomatic contact lens wearers, and to track circulating germs in LSCs that may affect the integrity of the eye.

METHODS

Demographic and behavioral data were collected from 111 asymptomatic lens wearers belonging to different medical faculties in Tunisia. Seventy LSCs were subjected to microbiological investigations, by direct examination and culture, in order to identify contaminating micro-organisms. The Richness and evenness of the species encountered were assessed to measure biodiversity on a local and international scale.

RESULTS

The study population was characterized by an average age of 22.8 ± 2.4 years and 95% female gender. Microbiological contamination accounted for 81.42% of LSCs, with only one case positive for Acanthamoeba spp. The Candida spp. fungal elements (20.0%) and Staphylococcus coagulase negative bacteria (60.5%) were the predominant microorganisms. Biodiversity markers namely: Simpson (0.802) and Shannon-Weiner (1.895) diversity indices were high in comparison to other studies. Monthly lens renewal (OR = 1.333, p = 0.040) and soft lens wear (OR = 4.66, p = 0.066) enhanced the installation of fungal elements.

CONCLUSIONS

The behaviors of contact lens wearers observed in this work corroborate those of all studies of contact lens wearers. The complexity of the recommended procedure and poor understanding of the instructions may explain any imperfections. This study highlights a high level of biodiversity in LSCs, and the strains in circulation are almost potentially pathogenic for humans.

Pan-azole resistance in clinical Aspergillus fumigatus isolates carrying TR34/L98H from birds and mammals in Belgium

Aspergillosis causes significant health risks to both birds and mammals. The outcome of these infections is often poor due to delayed diagnosis and treatment failure. We investigated 152 cases of aspergillosis from birds and mammals in Belgium. Most samples originated from the taxonomic orders Artiodactyla (40.1 %) and Columbiformes (19.7 %). Five isolates (3.3 %) showed phenotypical resistance against at least one medical azole. Three of these isolates were pan-azole resistant bearing the TR34/L98H mutation. The predominance of this resistance mutation supports an environmental route for exposure and resistance selection, highlighting the importance of the One Health concept.

Outbreaks in Health Care Settings

Outbreaks and pseudo-outbreaks in health care settings are complex and should be evaluated systematically using epidemiologic and molecular tools. Outbreaks result from failures of infection prevention practices, inadequate staffing, and undertrained or overcommitted health care personnel. Contaminated hands, equipment, supplies, water, ventilation systems, and environment may also contribute. Neonatal intensive care, endoscopy, oncology, and transplant units are areas at particular risk. Procedures, such as bronchoscopy and endoscopy, are sources of infection when cleaning and disinfection processes are inadequate. New types of equipment can be introduced and lead to contamination or equipment and medications can be contaminated at the manufacturing source.

A polymicrobial fungal outbreak in a regional burn center after Hurricane Sandy

OBJECTIVE

To describe a polymicrobial fungal outbreak after Hurricane Sandy.

DESIGN

An observational concurrent outbreak investigation and retrospective descriptive review.

SETTING

A regional burn intensive care unit that serves the greater Baltimore area, admitting 350-450 burn patients annually.

PATIENTS

Patients with burn injuries and significant dermatologic diseases such as toxic epidermal necrolysis who were admitted to the burn intensive care unit.

METHODS

An outbreak investigation and a retrospective review of all patients with non-candida fungal isolates from 2009-2016 were performed.

RESULTS

A polymicrobial fungal outbreak in burn patients was temporally associated with Hurricane Sandy and associated with air and water permeations in the hospital facility. The outbreak abated after changes to facility design.

CONCLUSIONS

Our results suggest a possible association between severe weather events like hurricanes and nosocomial fungal outbreaks. This report adds to the emerging literature on the effect of severe weather on healthcare-associated infections.

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.

Aspergillus and aspergilloses in wild and domestic animals: a global health concern with parallels to human disease

The importance of aspergillosis in humans and various animal species has increased over the last decades. Aspergillus species are found worldwide in humans and in almost all domestic animals and birds as well as in many wild species, causing a wide range of diseases from localized infections to fatal disseminated diseases, as well as allergic responses to inhaled conidia. Some prevalent forms of animal aspergillosis are invasive fatal infections in sea fan corals, stonebrood mummification in honey bees, pulmonary and air sac infection in birds, mycotic abortion and mammary gland infections in cattle, guttural pouch mycoses in horses, sinonasal infections in dogs and cats, and invasive pulmonary and cerebral infections in marine mammals and nonhuman primates. This article represents a comprehensive overview of the most common infections reported by Aspergillus species and the corresponding diseases in various types of animals.