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

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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.

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Acknowledgments

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).

Conflict of interest

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

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Authors and Affiliations

  1. Department of Hematology, Centre Henri Becquerel, 1 rue d’Amiens, 76000, Rouen, France

    Michael Loschi, Ali Chamseddine, Nathalie Contentin, Fabrice Jardin, Helene Lanic, Emilie Lemasle, Pascal Lenain, Aspasia Stamatoullas, Hervé Tilly & Stephane Lepretre

  2. Centre de Traitement des Données du Cancéropôle Nord-Ouest (CTD-CNO), Centre François Baclesse, 3 Avenue du Général Harris, 14076, Caen Cedex 05, France

    Caroline Thill

  3. Department of Microbiology, Centre Henri Becquerel, Rouen, France

    Christian Gray & Marion David

  4. Hygiene Unit, Centre Henri Becquerel, Rouen, France

    Marie-France Bagatha

Authors
  1. Michael Loschi
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  2. Caroline Thill
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  3. Christian Gray
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  4. Marion David
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  5. Marie-France Bagatha
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  6. Ali Chamseddine
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  7. Nathalie Contentin
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  8. Fabrice Jardin
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  9. Helene Lanic
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  10. Emilie Lemasle
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  11. Pascal Lenain
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  12. Aspasia Stamatoullas
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  13. Hervé Tilly
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  14. Stephane Lepretre
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Corresponding author

Correspondence to Stephane Lepretre.

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Loschi, M., Thill, C., Gray, C. et al. Invasive Aspergillosis in Neutropenic Patients During Hospital Renovation: Effectiveness of Mechanical Preventive Measures in a Prospective Cohort of 438 Patients. Mycopathologia 179, 337–345 (2015). https://doi.org/10.1007/s11046-015-9865-6

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  • DOI: https://doi.org/10.1007/s11046-015-9865-6

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