Invasive Aspergillosis in Neutropenic Patients During Hospital Renovation: Effectiveness of Mechanical Preventive Measures in a Prospective Cohort of 438 Patients

Michael Loschi, Caroline Thill, Christian Gray, Marion David, Marie France Bagatha, Ali Chamseddine, Nathalie Contentin, Fabrice Jardin, Helene Lanic, Emilie Lemasle, Pascal Lenain, Aspasia Stamatoullas, Hervé Tilly, Stephane Lepretre

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: Aspergillus species are the main cause of invasive fungal disease for patients with severe and prolonged neutropenia. Building or renovation works have been shown as one of the major causes of outbreaks of aspergillosis. Objectives: This study aimed to assess the effectiveness of introduction and adaptation by air sampling of mechanical preventive measures on the incidence of invasive pulmonary aspergillosis in neutropenic patients during hospital renovation. Patients: All of the patients admitted for prolonged and severe neutropenia during a renovation period from 2003 to 2008 were prospectively enrolled. Invasive pulmonary aspergillosis (IPA) cases were classified as possible, probable, and proven, according to the 2008 European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group criteria. The effectiveness of preventive measures was determined by air sampling. Results: We recorded 705 hospitalizations for neutropenia concerning 438 patients. The majority of hospitalized neutropenic patients was treated for acute leukemia (38.3 %), followed by patients suffering from non-Hodgkin and Hodgkin lymphomas (33 %). The total cumulative incidence of probable and proven IPA was 4.1 %. Risk factors for developing IPA were underlying disease, treatment course at the time of hospitalization, and the mean duration of hospitalization and of neutropenia. Conclusions: In this prospective study, the incidence of invasive pulmonary aspergillosis did not increase in neutropenic patients during a renovation period because of efficient mechanical preventive measures systematically adjusted using the results of air sampling.

Original languageEnglish (US)
Pages (from-to)337-345
Number of pages9
JournalMycopathologia
Volume179
Issue number5-6
DOIs
StatePublished - Feb 3 2015

Bibliographical note

Funding Information:
The authors would like to acknowledge the Centre de Traitement des Données du Cancéropôle Nord-Ouest for its assistance in collecting and analyzing the data. The CTD-CNO is supported by grants from the French National League Against Cancer (LNCC) and from the French National Cancer Institute (INCa).

Funding Information:
The authors received funding from Pfizer Pharmaceuticals to collect the data. However, Pfizer did not participate in either the data analyses or the writing.

Publisher Copyright:
© 2015, Springer Science+Business Media Dordrecht.

Keywords

  • Building works
  • Hematological malignancies
  • Invasive aspergillosis
  • Neutropenia
  • Prevention

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