TheICUpatientAmicrobiologistsprospective.pptVIP

Prevention of nosocomial infection Current recommendationsare they applicable to moulds Search for guidelines Prevention of nosocomial infection 31 hits Prevention of nosocomial mold/mould infection Zero (Prevention of nosocomial aspergillosis) 3 hits Guidelines Healthcare Infection Control Practices Advisory Committee (HICPAC) Guideline for Preventing Healthcare-Associated Pneumonia 2004 CDC Guideline for Environmental Infection Control in Health-Care Facilities, 2003 CDC Air Handling Systems Airborne Infectious Isolation (AII) Rooms Protective Environments (PE) Construction, Renovation, Remediation, Repair Demolition Invasive Aspergillus incidence increasing commonest cause of infectious death in many transplant units commonest cause of death in childhood leukaemia Increasing incidence? Disease Burden estimates (UK) Aspergillus in dust Risk of invasive aspergillosis IPA Angioinvasion by branching septate hyphae lead to infarction of tissues (wedge shaped) cavitation of lung dissemination Risk factors for aspergillosis Neutropenia steroids Environmental exposure Building work Compost heaps Marijuana smoking Outbreaks associated with building work Problems with air sampling Incubation period of IPA unknown Estimates vary from 48 hours -3 months Geographical and seasonal variation in spore counts and predominant species Variable efficiency of different air samplers May not take account of surface contamination Settle plates, contact plates, honey jars Air sampling Patients remain the most efficient “samplers” Intermittant periods of spore contamination likely to be missed Only useful retrospectively after clusters of disease appear Protected environment HEPA (for allogeneic HSCT patients only) 99.97% of all particles 3u diam) /=12 ACH Pressure differential 2 Pa Directed air flow Sealed rooms Respiratory protection (N95 respirator) if leaving room only during periods of building construction Standard hygiene barrier precautions No flowers, potted pla