Fungal infections after haematology unit renovation: evidence of clinical, environmental and economical impact

• Type: Article in International Scientific Journal
• Date: 2008

Authors

araujo, r (Author) Other; carneiro, a (Author) Other; costa-oliveira, s (Author) FMUP; pina-vaz, c (Author) FMUP; rodrigues, ag (Author) FMUP; guimaraes, je (Author) FMUP

Journal

Title: European Journal of Haematology

Vol. 80

Pages: 436-443

ISSN: 0902-4441

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 23 Citations

Scopus - 25 Citations

Pubmed / Medline

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

CORDIS: Health sciences

Other information

Authenticus ID: P-003-ZMN

DOI: 10.1111/j.1600-0609.2008.01034.x

Abstract (EN): Objectives: The Haemato-Oncology Unit, Hospital S. Joao, suffered extensive refurbishing intervention in order to adapt for autotransplant patients. Eight new individual rooms with central HEPA filtration system were built. All patients admitted in the department during 14 months prior to and 14 months after renovation works were enrolled. A total of 403 admissions were considered and a detailed analysis of all patients with fungal infections, air quality and antifungal consumption were evaluated in order to study clinical, environmental and economical impact after unit renovation. Results: Patients with acute myeloid leukaemia submitted to induction treatment were the most susceptible to acquisition of fungal infections. Fungal infections were reduced after installation of HEPA filters in individual rooms, particularly proven and probable fungal infections. No patients were diagnosed with proven or probable mould infection in the period after the unit renovation and no deaths were registered among patients with the diagnosis of possible fungal infection. Considering the group of patients diagnosed with fungal infection, the average of hospitalization was reduced 3 d in the latter period. The new high-protected rooms showed a reduction of 50% and 95% of airborne fungi, respectively in the first week and after the second week. The consumption of voriconazole and caspofungin was reduced, respectively, 66% and 59% and the final cost with antifungal therapy was reduced by 17.4%. Conclusions: Autotransplant patients may be under higher risk of infection, however, the installation of high-protective measures may efficiently prevent fungal infections in these patients. Renovation of haematology unit resulted in major clinical, environmental and economical improvements. The definition of reference values for airborne agents in hospital facilities remains urgent.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8