RESEARCH PAPER
Fungal contamination of ward furnishings and medical equipment used in the treatment and nursing of newborns
1
Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
2
Dr Jan Bobr Centre for Microbiology and Vaccines, Krakow, Poland
3
Clinical Department of Neonatology, University Hospital, Krakow, Poland
4
Department of Microbiology, Jagiellonian University Medical College, Krakow, Poland
Corresponding author
Agnieszka Gniadek
Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College in Krakow, Poland, Kopernika 25 Street, 31-501, Kraków, Poland
Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College in Krakow, Poland, Kopernika 25 Street, 31-501, Kraków, Poland
Ann Agric Environ Med. 2020;27(3):348–355
KEYWORDS
TOPICS
Biological agents posing occupational risk in agriculture, forestry, food industry and wood industry and diseases caused by these agents (zoonoses, allergic and immunotoxic diseases)State of the health of rural communities depending on various factors: social factors, accessibility of medical care, etc.
ABSTRACT
Introduction and objective:
Newborn babies staying on hospital wards are likely to be colonized by microorganisms, including potentially pathogenic fungi. The aim of the study was to assess the mycological purity of hospital wards and medical equipment utilized in the treatment and nursing of newborns.
Material and methods:
The study was conducted in Neonatal High Dependency Units (NHDU) and Neonatal Intensive Care Units (NICU). 539 samples were collected from 24 different sources, 130 from ward furnishings and 289 from medical equipment. The study was carried out following the microbiology research methods for sample collection. Subsequently, the samples (swabs, water from incubators, washings from respirator tubes and nasal cannulas (nCPAP)) were cultivated on Sabouraud agar plates. The stamps were collected with the application of Count-Tact method. The samples were incubated at the temperature of 25+/-2 o C and the number of fungi assessed (cfu/cm -2 of the surface area). The species were identified based on their morphological and biochemical features.
Results:
Fungal growth was observed on 60% of samples collected from ward furnishings and 7% of samples collected from medical equipment. The average number of cfu/cm -2 ranged between 0–8.84 in the case of ward furnishings and between 0–1.22 cfu/cm -2 in the case of medical equipment. In 180 samples collected from the material which had direct contact with newborns no fungal growth was observed.
Conclusions:
The furnishings of the wards on which newborns were treated and nursed were contaminated with fungi to an extent which did not pose a threat to the life and health of the newborns. Medical equipment (respirators, incubators, nCPAP cannulas and masks) which came into direct contact with newborns was free from fungi.
Newborn babies staying on hospital wards are likely to be colonized by microorganisms, including potentially pathogenic fungi. The aim of the study was to assess the mycological purity of hospital wards and medical equipment utilized in the treatment and nursing of newborns.
Material and methods:
The study was conducted in Neonatal High Dependency Units (NHDU) and Neonatal Intensive Care Units (NICU). 539 samples were collected from 24 different sources, 130 from ward furnishings and 289 from medical equipment. The study was carried out following the microbiology research methods for sample collection. Subsequently, the samples (swabs, water from incubators, washings from respirator tubes and nasal cannulas (nCPAP)) were cultivated on Sabouraud agar plates. The stamps were collected with the application of Count-Tact method. The samples were incubated at the temperature of 25+/-2 o C and the number of fungi assessed (cfu/cm -2 of the surface area). The species were identified based on their morphological and biochemical features.
Results:
Fungal growth was observed on 60% of samples collected from ward furnishings and 7% of samples collected from medical equipment. The average number of cfu/cm -2 ranged between 0–8.84 in the case of ward furnishings and between 0–1.22 cfu/cm -2 in the case of medical equipment. In 180 samples collected from the material which had direct contact with newborns no fungal growth was observed.
Conclusions:
The furnishings of the wards on which newborns were treated and nursed were contaminated with fungi to an extent which did not pose a threat to the life and health of the newborns. Medical equipment (respirators, incubators, nCPAP cannulas and masks) which came into direct contact with newborns was free from fungi.
REFERENCES (36)
1.
Pegues D, Lasker B, McNeil M, Hamm P, Lundal J, Kubak B. Cluster of cases of invasive aspergillosis in a transplant intensive care unit: evidence of person-to-person airborne transmission. Clin Infect Dis.2002; 34: 412–416.
2.
Perdelli F, Cristina M.L, Spagnolo A.M, Dallera B.S, Ottria G, Grimaldi M. Fungal contamination in hospital environments. Infect Control Hosp Epidemiol. 2006; 27: 44–47.
3.
Faure O, Fricker-Hidalgo H, Lebeau B, Ambroise-Thomas P. Eight-year surveillance of environmental fungal contamination in hospital operating rooms and haematological units. J Hosp Infect. 2002; 11: 155–160.
4.
Fox B.C, Chamberlin L, Kulich P, Rae E.J, Webster L.R. Heavy contamination of operating room air by Penicillium species. Identification of the source and attempts at decontamination. Am J Infect Control. 1990; 11: 300–306.
5.
Panagopoulou P, Filioti J, Farmaki E, Avgi M.M, Roilides E. Filamentous fungi in a tertiary care hospital: environmental surveillance and susceptibility to antifungal drugs. Infect Control Hosp Epidemiol. 2007; 28: 60–67.
6.
Westerling G, Davis M, Khuon D. Do donated linens put patients at risk for fungal infections during hospitalization? A pediatric case investigation and subsequently implemented process changes. Am J Infect Control. 2018; 46: 118–119.
7.
Anaissie E.J, Stratton S.L, Dignani M.C, Lee C.K, Summerbell R.C, Rex J.H, Monson T.P, Walsh T.J. Pathogenic molds (including Aspergillus species) in hospital water distribution systems: a 3-year prospective study and clinical implications for patients with hematologic malignancies. Blood. 2003; 101: 2542–2546.
8.
Richardson M. The ecology of the Zygomycetes and its impact on environmental exposure. Clin Microbiol Infect. 2009; 15: (Suppl 5): 2–9.
9.
Morio F, Horeau-Langlard D, Gay-Andrieu F, Talarmin J.P, Haloun A, Treilhaud M, Despins P, Jossic F, Nourry L, Danner-Boucher I, Pattier S, Bouchara J.P, Le Pape P, Miegeville M. Disseminated Scedosporium/Pseudallescheria infection after double-lung transplantation in patients with Cystic Fibrosis. J Clin Microbiol. 2010; 48: 1978–1982.
10.
Cheng V.C.C, Chen J.H.K, Wong S.C.Y, Leung S.S.M, So S.Y.C, Lung D.C, Lee W.M, Trendell-Smith N.J, Chan W.M, Ng D, To L, Lie A.K.W, Yuen K.Y. Hospital outbreak of pulmonary and cutaneous Zygomycosis due to contaminated linen items from substandard laundry.Clin Infect Dis. 2016; 62: 714–721.
11.
Kriengkauykiat J, Ito J.I, Dadwal S.S. Epidemiology and treatment approaches in management of invasive fungal infections. Clin Epidemiol. 2011; 3: 175–191.
12.
Gniadek A, Macura A.B. Środowisko oddziału szpitalnego jako potencjalne ryzyko zakażeń grzybami pleśniowymi u noworodka. Postępy Neonatologii. 2008; 12: 15–19. (In Polish).
13.
Puopolo K M. Bacterial and Fungal Infections. In: Cloherty and Stark’s Manual of Neonatal Care Eichenwald Hansen EC, Martin AR, Stark CR, Ed. Wolters Kluwer, Philadelphia 2017, pp. 684–719.
14.
de Hoog GS, Guarro J, Gene J, Figueras MJ. Atlas of clinical fungi, 2nd ed. Centraalbureau voor Schimmelcultres. Urtrech, The Netherland 2000.
15.
Watanabe T. Pictorial Atlas of Soil and Seed Fungi: Morphologies of Cultured Fungi and Key to Species, Third Edition. CRC Press, London 2010.
16.
Gniadek A. Kontrola czystości środowiska szpitalnego. In Zakażenia szpitalne w jednostkach opieki zdrowotnej. Bulanda M, Wójkowska – Mach J. Ed. PZWL, Warszawa, Poland, 2016; pp. 465–467. (In Polish).
17.
Gangneux JP. Prevention of nosocomial invasive aspergillosis: protective measures and environmental surveillance. Medical Mycology. 2004; 11: 153–155.
18.
Charkowska A. Normy czystości powietrza i powierzchni szpitalnych. Zakażenia. 2006, 1, 76–78. (In Polish).
19.
Galvin S, Dolan A, Cahill O, Daniels S, Humphreys H. Microbial monitoring of the hospital environment: why and how? J Hosp Infect.2012; 82: 143–151.
20.
Ellingson K, Haas JP, Aiello AE, Kusek L, Maragakis LL, Olmsted RN, Perencevich E, Polgreen PM, Schweizer ML, Trexler P, et al. Strategies to prevent healthcare-associated infections through hand hygiene. Infect Control Hosp Epidemiol. 2014; 35: 937–960.
21.
Wałaszek M, Kołpa M, Wolak Z, Różańska A, Wójkowska-Mach J. Poor Hand Hygiene Procedure Compliance among Polish Medical Students and Physicians—The Result of an Ineffective Education Basis or the Impact of Organizational Culture? Int J Environ Res Public Health 2017; 14: 1026.
22.
Różańska A, Bulanda M. Demographic characteristics of patients and their assessment of selected hygienic practices of hospital personnel in the context of safety climate of hospitalization. Am J Infect Control. 2015; 43: 354–357.
23.
Hamada N, Fujita T. Effect of air – conditioner on fungal contamination. Atmospheric Environ. 2002; 36: 5443–5448.
24.
Kasprzyk I. Aeromycology – main research fields of interest during the last 25 years. Ann Agric Environ Med. 2008; 15: 1–7.
25.
Jackson S, Smikle M, Antoine M, Roberts G. Paecilomyces lilacinus fungemia in a Jamaican neonate. West Indian Med J. 2006; 55: 360–360.
26.
Lyratzopoulos G, Ellis M, Nerringer R, Denning D.W. Invasive infection due to penicillium species other than P. marneffei. J Infect. 2002; 45: 184–95.
27.
Caggiano G, Napoli C, Coretti C, Lovero G, Scarafile G , De Giglio O, Montagna M.T. Mold contamination in a controlled hospital environment: a 3-year surveillance in southern Italy. BMC Infect Dis. 2014; 15: 595.
28.
Gniadek A, Macura A.B, Górkiewicz M. Cytotoxicity of Aspergillus fungi isolated from hospital environment. Pol J Microbiol. 2011; 60: 59–63.
29.
Gniadek A, Krzyściak P, Twarużek M, Macura A.B. Occurrence of fungi and cytotoxicity of the species: Aspergillus ochraceus, Aspergillus niger and Aspergillus flavus isolated from the air of hospital wards. Int J Occup Med Environ Health. 2017; 30: 231–239.
30.
Gutarowska B, Skóra J, Stępień Ł, Twarużek M, Błajet-Kosicka A, Otlewska A, Grajewski. J. Estimation of fungal contamination and mycotoxin production at workplaces in composting plants, tanneries, archives and libraries. World Mycotoxin J. 2014; 7: 345–355.
31.
Rozporządzenie Ministra Zdrowia z dnia 22 kwietnia 2005 r. w sprawie szkodliwych czynników biologicznych dla zdrowia w środowisku pracy oraz ochrony zdrowia pracowników zawodowo narażonych na te czynniki. Dz. U. 2005 nr 81poz. 716.
32.
Baranyi N, Despot D.J, Palágyi A, Kiss N, Kocsubé S, Szekeres A, Kecskeméti A, Bencsik O, Vágvölgyi C, Klarić M.Š, Varga J. Identification of Aspergillus species in Central Europe able to produce G-type aflatoxins. Acta Biol Hung. 2015; 66: 339–347,.
33.
Zhao Q, Chen Y, Wang Y, Xu D.D. Clinical features and hospital costs of neonatal sepsis caused by bacteria and fungi: a comparative analysis. Zhongguo Dang Dai Er Ke Za Zhi. 2016; 18: 311–315.
34.
Groll A.H, Jaeger G, Allendorf A, Herrmann G, Schloesser R, von Loewenich V. Invasive pulmonary aspergillosis in a critically ill neonate: case report and review of invasive aspergillosis during the first 3 months of life. Clin Infect Dis. 1998; 27: 437–52.
35.
Tatara AM, Mikos AG, Kontoyiannis DP. Factors affecting patient outcome in primary cutaneous aspergillosis. Medicine 2016; 95: e3747.
36.
Etienne KA, Subudhi CPK, Chadwick PR, Settle P, Moise J, Magill SS, Chiller T, Balajee SA. Investigation of a cluster of cutaneous aspergillosis in a neonatal intensive care unit. J Hosp Infect. 2011; 79: 344–348.
Share
RELATED ARTICLE
Improvement of visual identification of the journal - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher Education allocated to the activities of disseminating science.
Generation of the DOI (Digital Object Identifier) - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.