Environment surveillance of filamentous fungi in two tertiary care hospitals in China
Environment surveillance of filamentous fungi in two tertiary care hospitals in China
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DOI：
10.3760/cma.j.issn.0366-6999.2011.13.009
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发表时间：
2011-07-05
影响因子：
6.1
通讯作者：
Zhang Jie
中科院分区：
文献类型：
--
作者：
Hao Zhen-feng;Ao Jun-hong;Zhang Jie
背景侵袭性真菌感染已成为免疫功能低下患者发病和死亡的重要原因。方法在中国北方和西南地区的两所三级医院进行为期一年的监测。在中央重症监护室、骨髓移植室、神经外科重症监护室和活体移植部门，每月对空气、表面和自来水进行两次采样。结果西南医院和北方医院空气真菌载量分别为91.94cfu/m3和71.02cfu/m3，两医院空气真菌载量差异有统计学意义（P <0.05）。从空气和表面收集的五种最普遍的真菌是青霉属，枝孢属，链格孢属，曲霉属和酵母属（Saccharomyces spp.）在中国西南医院，同时青霉属，镰刀菌属，曲霉属，链格孢和枝孢属（Cladosperium spp.）在北方中国医院。污染最轻的科室是重症监护病房，污染最重的科室是神经外科重症监护病房。在北方中国医院和西南中国医院检查的所有表面中，分别有73%和86%产生了真菌。北方医院和西南医院的水样真菌检出率分别为54%和49%。空气和地表真菌负荷在一年中波动。空气真菌负荷冬季较低，夏秋季较高，但很少超过可接受水平。北方医院5 - 8月、西南医院5 - 6月和9 - 10月的数值较高。空气真菌负荷和湿度之间的相关性，以及人员进行了观察。中华医学杂志2011;124（13）：1970-1975
Background Invasive fungal infections have constituted an increasingly important cause of morbidity and mortality in immunocompromised patients. In this study, a surveillance project was conducted in three different intensive care units of two large tertiary hospitals in China.Methods A one-year surveillance project was conducted in two tertiary hospitals which located in northern China and southwest China respectively. Air, surfaces and tap water were sampled twice a month in a central intensive care unit, a bone marrow transplant unit, a neurosurgery intensive care unit and a live transplant department. Environmental conditions such as humidity, temperature and events taking place, for example the present of the visitors, healthcare staff and cleaning crew were also recorded at the time of sampling.Results The air fungal load was 91.94 cfu/m(3) and 71.02 cfu/m(3) in the southwest China hospital and the northern China hospital respectively. The five most prevalent fungi collected from air and surfaces were Penicillium spp., Cladosperium spp., Alternaria spp., Aspergillus spp. and Saccharomyces spp. in the southwest China hospital, meanwhile Penicillium spp., Fusarium spp., Aspergillus spp., Alternaria spp. and Cladosperium spp. in the northern China hospital. The least contaminated department was intensive care units, and the heaviest contaminated department was neurosurgery intensive care unit. Seventy-three percent of all surfaces examined in the northern China hospital and eighty-six percent in the southwest China hospital yielded fungi. Fifty-four percent of water samples from the northern China hospital and forty-nine percent from the southwest China hospital yielded fungi.Conclusions These findings suggested that the fungus exist in the environment of the hospital including air, surface and water. Air and surface fungal load fluctuated over the year. Air fungal load was lower in winter and higher in summer and autumn, but seldom exceeded acceptable level. The higher values were created during May to August in the northern China hospital and May to June and September to October in the southwest China hospital. A correlation between air fungal load and humidity, as well as personnel was observed. Chin Med J 2011;124(13):1970-1975