Fungal aerocontamination exposure risk for patients in 3 successive locations of a pediatric hematology unit department: Influence of air equipment and building structure on air quality


      • Renovation of an old building did not significantly improve air quality.
      • Rooms with laminar air flow were the only safe solution for deeply immunocompromised patients.
      • Corridors are reliable sentinels to alert caregivers and medical staff in case of a fungal contamination outbreak in patient rooms.


      Invasive fungal infections (IFIs) play an important role in the mortality of immunocompromised patients. The pediatric hematology department (PHD) at Besançon University Hospital has relocated 3 times: (1) from a building without an air filtration system (B1), (2) to a renovated building with low air pressure (B2), and (3) to a new building with high air pressure and high-efficiency particulate air filters (B3). This study aimed to investigate how these relocations influenced the fungal exposure risk for the PHD's patients.


      Air samples were taken monthly in patient rooms and weekly in corridors. The detection of opportunistic fungi species was used to assess IFI risk. Data were analyzed using univariate and multivariate random-effects negative binomial regression.


      A total of 1,074 samples from 29 rooms over a 10-year period showed that renovation of an old building with a basic ventilation system did not lead to a significant improvement of air quality (P = .004, multivariate analysis). Among factors linked to higher risk of patient rooms mold contamination was fungal contamination of the corridors (P < .001).


      This study demonstrates that corridors can be used as reliable sentinel to prevent fungal contamination in patient rooms. Only relocation in building B3, equipped with laminar air flow, achieved adequate air quality.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Passweg J.R.
        • Rowlings P.A.
        • Atkinson K.A.
        • Barrett A.J.
        • Gale R.P.
        • Gratwohl A.
        • et al.
        Influence of protective isolation on outcome of allogeneic bone marrow transplantation for leukemia.
        Bone Marrow Transplant. 1998; 21: 231-1238
        • Bergeron V.
        • Reboux G.
        • Poirot J.L.
        • Laudinet N.
        Decreasing airborne contamination levels in high-risk hospital areas using a novel mobile air-treatment unit.
        Infect Control Hosp Epidemiol. 2007; 28: 1181-1186
        • Reboux G.
        • Gbaguidi-Haore H.
        • Bellanger A.P.
        • Demonmerot F.
        • Houdrouge K.
        • Deconinck E.
        • et al.
        A 10-year survey of fungal aerocontamination in hospital corridors: a reliable sentinel to predict fungal exposure risk?.
        J Hosp Infect. 2014; 87: 34-40
        • Ascioglu S.
        • Rex J.H.
        • de Pauw B.
        • Bennett J.E.
        • Bille J.
        • Crokaert F.
        • et al.
        Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus.
        Clin Infect Dis. 2002; 34: 7-14
        • De Pauw B.
        • Walsh T.J.
        • Donnelly J.P.
        • Stevens D.A.
        • Edwards J.E.
        • Calandra T.
        • et al.
        Revised definitions of invasive fungal disease from the 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.
        Clin Infect Dis. 2008; 46: 1813-1821
        • Millon L.
        • Larosa F.
        • Lepiller Q.
        • Legrand F.
        • Rocchi S.
        • Daguindau E.
        • et al.
        Quantitative polymerase chain reaction detection of circulating DNA in serum for early diagnosis of mucormycosis in immunocompromised patients.
        Clin Infect Dis. 2013; 56: 95-101
        • Engelhart S.
        • Hanfland J.
        • Glasmacher A.
        • Krizek L.
        • Schmidt-Wolf I.G.H.
        • Exner M.
        Impact of portable air filtration units on exposure of haematology-oncology patients to airborne Aspergillus fumigatus spores under field conditions.
        J Hosp Infect. 2003; 54: 300-304
        • Cheng S.M.
        • Streifel A.J.
        Infection control considerations during construction activities: land excavation and demolition.
        Am J Infect Control. 2001; 29: 321-328
      1. [Consensus conference: preventing the risk of Aspergillus infection in immunocompromised patients].
        Bull Cancer. 2001; 88: 589-600