Airborne Fungi in a Neonatal Intensive Care Unit and Operating Theater in a University Hospital
DOI:
https://doi.org/10.31686/ijier.vol10.iss2.3629Keywords:
airborne fungi, indoor air quality, yeasts, fungal infection, indoor environmentAbstract
Monitoring the microbiological quality of indoor air in hospital environments is a matter of comprehensive discussion due to its influence on the transmission and spread of pathogenic microorganisms. Among the artificially air-conditioned environments, hospitals are noteworthy for being specific places for the treatment and recovery of patients. In addition to problems related to patients health and professionals health, immunocompromised patients are more exposed to microorganisms present in the air currents of the refrigeration system in these environments, which can lead to consequences such as the occurrence of outbreaks. The objective of this work was to evaluate the indoor air quality in critical hospital environments of a teaching hospital in the city of Maceió, the state of Alagoas. In addition, we sought to identify the anemophilous fungal microbiota present. Air collections were taken in the rainy season, totaling, following recommendations indicated by Resolution No. 9 of the Brazilian National Health Surveillance Agency. The study was based on determining the concentration parameter of bioaerosols in indoor and outdoor air. The fungal microbiota identification was carried out by analyzing macro and microscopic characteristics for filamentous fungi and the use of molecular tools for yeasts. The most frequent species in hospital critical environments were Cladosporium cladosporioides, Penicillium piceum, Penicillium aurantiogriseum, Cladosporium herbarum and Aspergillus oryzae. In outdoor air, the most frequently found fungi were Penicillium sp., Aspergillus sp., and Cladosporium species. Candida tropicalis, C. krusei, and C. parapsilosis were identified among the yeasts in indoor and outdoor air samples. Identifying potentially pathogenic fungi in the evaluated environments points to the need for continuous monitoring of indoor air quality. Furthermore, to avoid the widespread fungal pathogens and the consequent occurrence of outbreaks, the adoption of indoor air microbiological quality analysis programs is suggested as an essential tool in developing infection control standards. In our study, airborne fungi are reported as indoor air contaminants in critical hospital environments. This finding is noteworthy because, in general, individuals present in these environments have an immunological impairment.
Downloads
References
ABDEL-AZIZ, R. A.-Z.; RADWAN, S. M. Microbial pollution of indoor air in Riyadh city government schools. World Journal of Advanced Research and Reviews, v. 8, n. 1, p. 209–216, 2020.
ATCHADE, E. et al. Fatal invasive aspergillosis caused by Aspergillus niger after bilateral lung transplantation. Medical mycology case reports, v. 17, p. 4–7, 2017.
AWOSIKA, S. A.; OLAJUBU, F. A.; AMUSA, N. A. Microbiological assessment of indoor air of a teaching hospital in Nigeria. Asian pacific journal of tropical biomedicine, v. 2, n. 6, p. 465–468, 2012.
BEENA, H.; GUPTA, M.; KINDO, A. J. Pulmonary infection with Penicillium citrinum in a patient with multiple myeloma. Indian journal of medical microbiology, v. 39, n. 2, p. 259–261, 2021.
BELIZARIO, J. A.; LOPES, L. G.; PIRES, R. H. Fungi in the indoor air of critical hospital areas: a review. Aerobiologia, p. 1–16, 2021.
BOŽIĆ, J.; ILIĆ, P.; ILIĆ, S. Indoor air quality in the hospital: The influence of heating, ventilating and conditioning systems. Brazilian archives of biology and technology, v. 62, 2019.
CALUMBY, R. J. N. et al. Isolamento e identificação da microbiota fúngica anemófila em Unidade de Terapia Intensiva. Brazilian Journal of Development, v. 5, n. 10, p. 19708–19722, 2019.
CASTELLANI, A. The “water cultivation” of pathogenic fungi. The journal of tropical medicine and hygiene, v. 66, p. 283–284, 1963.
CORDEIRO, R. A. et al. Isolation of pathogenic yeasts in the air from hospital environments in the city of Fortaleza, northeast Brazil. The Brazilian journal of infectious diseases: an official publication of the Brazilian Society of Infectious Diseases, v. 14, n. 1, p. 30–34, 2010.
DE HOOG, Gerrit S. et al. Atlas of clinical fungi. Centraalbureau voor Schimmelcultures (CBS), 2000.
DEMIREL, R. et al. Indoor airborne fungal pollution in newborn units in Turkey. Environmental monitoring and assessment, v. 189, n. 7, 2017.
DEY, D.; GHOSAL, K.; BHATTACHARYA, S. G. Aerial fungal spectrum of Kolkata, India, along with their allergenic impact on the public health: a quantitative and qualitative evaluation. Aerobiologia, v. 35, n. 1, p. 15–25, 2019.
DHAR, D. G. et al. Assessment of airborne fungi in childrens hospital located in Kolkata India. Defence life science journal, v. 6, n. 3, p. 228–234, 2021.
DO NASCIMENTO, J. P. M. et al. Airborne fungi in indoor hospital environments. International journal of current microbiology and applied sciences, v. 8, n. 01, p. 2749–2772, 2019.
EGBUTA, M.; MWANZA, M.; BABALOLA, O. Health risks associated with exposure to filamentous fungi. International journal of environmental research and public health, v. 14, n. 7, p. 719, 2017.
GELTNER, C. et al. Invasive pulmonary mycosis due to Penicillium chrysogenum: a new invasive pathogen: A new invasive pathogen. Transplantation, v. 95, n. 4, p. e21-3, 2013.
GELTNER, C. et al. Invasive pulmonary mycosis due to Penicillium chrysogenum: a new invasive pathogen: A new invasive pathogen. Transplantation, v. 95, n. 4, p. e21-3, 2013.
GODOY, P. et al. Onychomycosis caused by Fusarium solani and Fusarium oxysporum in São Paulo, Brazil. Mycopathologia, v. 157, n. 3, p. 287–290, 2004.
GONÇALVES, C. L. et al. Airborne fungi in an intensive care unit. Brazilian Journal of Biology, v. 78, n. 2, p. 265–270, 2017.
GONG, X. et al. Invasive candidiasis in intensive care units in China: Risk factors and prognoses of Candida albicans and non–albicans Candida infections. American journal of infection control, v. 44, n. 5, p. e59–e63, 2016.
GUO, J. et al. Characteristics of airborne bacterial communities in indoor and outdoor environments during continuous haze events in Beijing: Implications for health care. Environment international, v. 139, n. 105721, p. 105721, 2020.
HAKAMIFARD, A. et al. Fatal disseminated aspergillosis in an immunocompetent patient with COVID-19 due to Aspergillus ochraceus. Journal de mycologie medicale, v. 31, n. 2, p. 101124, 2021.
HEUTTE, N. et al. Assessment of multi-contaminant exposure in a cancer treatment center: a 2-year monitoring of molds, mycotoxins, endotoxins, and glucans in bioaerosols. Environmental monitoring and assessment, v. 189, n. 1, 2017.
HOOGERVORST-SCHILP, J. et al. Excess length of stay and economic consequences of adverse events in Dutch hospital patients. BMC health services research, v. 15, n. 1, p. 531, 2015.
JAMIU, A. T. et al. Update on Candida krusei, a potential multidrug-resistant pathogen. Medical mycology: official publication of the International Society for Human and Animal Mycology, v. 59, n. 1, p. 14–30, 2021.
KIASAT, N. et al. Qualitative and quantitative assessment of airborne fungal spores in the hospitals environment of Ahvaz city (2016). Jundishapur journal of microbiology, v. 10, n. 10, 2017.
LACAZ, C. da S. et al. Tratado de micologia médica. 2002.
LARREY, E. K. et al. Microbial load of indoor airborne bacteria and fungi in a teaching hospital in Ghana. African journal of microbiology research, v. 14, n. 3, p. 100–105, 2020.
MIRHOSEINI, S. H. et al. Indoor exposure to airborne bacteria and fungi in sensitive wards of an academic pediatric hospital. Aerobiologia, v. 36, n. 2, p. 225–232, 2020.
MONTAZERI, A. et al. Microbiological analysis of bacterial and fungal bioaerosols from burn hospital of Yazd (Iran) in 2019. Journal of environmental health science & engineering, v. 18, n. 2, p. 1121–1130, 2020.
NASIRI, N. et al. Contamination of obsterics and gynecology hospital air by bacterial and fungal aerosols associated with nosocomial infections. Journal of environmental health science & engineering, v. 19, n. 1, p. 1–8, 2021.
PÉREZ-CANTERO, A.; GUARRO, J. Current knowledge on the etiology and epidemiology of Scopulariopsis infections. Medical mycology: official publication of the International Society for Human and Animal Mycology, v. 58, n. 2, p. 145–155, 2020.
RASMEY, A. H. M. ABOSEIDAH, A. A., EL-BEALY, E. M. Occurrence and Frequency of Outdoor and Indoor Airborne Fungi of Suez General Hospital, Suez, Egypt. Catrina, v. 17, n. 1, p. 15–23, 2018.
RIDDELL, R. W. Permanent stained mycological preparations obtained by slide culture. Mycologia, v. 42, n. 2, p. 265, 1950.
ROSTAMI, N. et al. Assessment of indoor and outdoor airborne fungi in an Educational, Research and Treatment Center. Italian journal of medicine, v. 10, 2017.
SAAD-HUSSEIN, A.; IBRAHIM, K. S. Health impact of airborne fungi. In: Handbook of Healthcare in the Arab World. Cham: Springer International Publishing, 2021. p. 1421–1435.
SANTOS, A. F. et al. Best practices on HVAC design to minimize the risk of COVID-19 infection within indoor environments. Brazilian Archives of Biology and Technology, v. 63, 2020.
SATTAR, S. A. Indoor air as a vehicle for human pathogens: Introduction, objectives, and expectation of outcome. American journal of infection control, v. 44, n. 9, p. S95–S101, 2016.
SOUZA, A. K. P. et al. Airborne fungi in neonatal intensive care unit of a public hospital in Brazil. International journal of current microbiology and applied sciences, v. 8, n. 12, p. 1210–1219, 2019.
STOCKWELL, R. E. et al. Indoor hospital air and the impact of ventilation on bioaerosols: a systematic review. The journal of hospital infection, v. 103, n. 2, p. 175–184, 2019.
VAN TRAN, V.; PARK, D.; LEE, Y.-C. Indoor air pollution, related human diseases, and recent trends in the control and improvement of indoor air quality. International journal of environmental research and public health, v. 17, n. 8, p. 2927, 2020
ZAKHEM, A. E. et al. Predominance of Candida glabrata among non-albicans Candida species in a 16-year study of candidemia at a tertiary care center in Lebanon. Pathogens, v. 10, n. 1, p. 82, 2021.
ZIAEE, A.; ZIA, M.; GOLI, M. Identification of saprophytic and allergenic fungi in indoor and outdoor environments. Environmental monitoring and assessment, v. 190, n. 10, p. 574, 2018.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Krystianelly Patricia Pedrosa, Jean Phellipe Marques do Nascimento, Mykaella Andrade de Araújo, Mirna Samile dos Santos Silva, Daniela Évelin dos Santos, Euripedes Alves da Silva-Filho

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyrights for articles published in IJIER journals are retained by the authors, with first publication rights granted to the journal. The journal/publisher is not responsible for subsequent uses of the work. It is the author's responsibility to bring an infringement action if so desired by the author for more visit Copyright & License.