Background
Worldwide, the frequency of invasive fungal infections has been increasing, with a
corresponding increase in the numbers of high-risk patients. Exposure reduction through
the use of high-efficiency particulate air (HEPA) filters has been the preferred primary
preventive strategy for these high-risk patients. Although the efficiency and benefits
of fixed HEPA filters is well proven, the benefits of portable HEPA filters are still
inconclusive.
Methods
This was a retrospective study to assess the impact of 48 portable HEPA filter units
deployed in selected wards in Singapore General Hospital, an acute tertiary-care hospital
in Singapore. Data were extracted between December 2005 and June 2008 on the diagnoses
at discharge and microbiological and histological laboratory findings. All patients
with possible, probable, or proven invasive aspergillosis (IA) were included.
Results
In wards with portable HEPA filters, the incidence rate of IA of 34.61/100,000 patient-days
in the preinstallation period was reduced to 17.51/100,000 patient-days in the postinstallation
period (P = .01), for an incidence rate ratio of 1.98 (95% confidence interval [CI], 1.10-2.97).
In wards with no HEPA filters, there was no significant change in the incidence rate
during the study period. Portable HEPA filters were associated with an adjusted odds
ratio of 0.49 (95% CI, 0.28-0.85; P = .01), adjusted for diagnosis and length of hospital stay.
Conclusions
Portable HEPA filters are effective in the prevention of IA. The cost of widespread
portable HEPA filtration in hospitals will be more than offset by the decreases in
nosocomial infections in general and in IA in particular.
Key Words
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Article Info
Publication History
Published online: February 03, 2010
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2010 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
