Effectiveness of environmental control measures to decrease the risk of invasive aspergillosis in acute leukaemia patients during hospital building work

J Hosp Infect. 2017 Aug;96(4):336-341. doi: 10.1016/j.jhin.2017.04.022. Epub 2017 May 5.

Abstract

Background: Invasive aspergillosis (IA) is a significant problem in acute leukaemia patients. Construction work near hospital wards caring for immunocompromised patients is one of the main risk factors for developing invasive pulmonary aspergillosis (IPA).

Aim: To assess the impact of environmental control measures used during hospital construction for the prevention of IA in acute leukaemia patients.

Methods: A retrospective cohort study was developed to evaluate the IA incidence in acute leukaemia patients with different environmental control measures employed during hospital construction. We used European Organisation for the Research and Treatment of Cancer (EORTC) criterial diagnosis parameters for definition of IA.

Findings: A total of 175 episodes of inpatient care were evaluated, 62 of which did not have any environmental control measures (when an outbreak occurred), and 113 that were subject to environmental control measures directed to preventing IA. The study showed an IA incidence of 25.8% for the group without environmental control measures vs 12.4% for those who did receive environmental control measures (P=0.024). The relative risk for IA was 0.595 (95% confidence interval: 0.394-0.897) for the group with environmental control measures.

Conclusion: The current study suggests that the implementation of environmental control measures during a hospital construction has a positive impact for prevention of IA in patients hospitalized with acute leukaemia.

Keywords: Aspergillosis; Hospital construction; Leukaemia; Lymphoblastic lymphoma; Myeloid.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Hospital Design and Construction*
  • Humans
  • Immunocompromised Host*
  • Incidence
  • Infection Control / methods*
  • Invasive Pulmonary Aspergillosis / epidemiology
  • Invasive Pulmonary Aspergillosis / prevention & control*
  • Leukemia / complications*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult