Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-04T21:43:54.024Z Has data issue: false hasContentIssue false
  • English
  • Français

The Plasmair Decontamination System Is Protective Against Invasive Aspergillosis in Neutropenic Patients

Published online by Cambridge University Press:  08 April 2016

Marie-Paule Fernandez-Gerlinger ,
Anne-Sophie Jannot ,
Sophie Rigaudeau ,
Juliette Lambert ,
Odile Eloy ,
François Mignon ,
Hassan Farhat ,
Sylvie Castaigne ,
Jacques Merrer  and
Philippe Rousselot
Marie-Paule Fernandez-Gerlinger*
Affiliation:
Service de Biologie Médicale, Centre Hospitalier de Versailles, Le Chesnay, France
Anne-Sophie Jannot
Affiliation:
Service d’informatique médicale, de biostatistique et de Santé Publique, Hôpital européen Georges Pompidou, AP-HP, Paris, France Faculté de Médecine Paris Descartes, Université Paris Descartes, Paris, France INSERM, Centre de Recherche des Cordeliers, UMRS 1138
Sophie Rigaudeau
Affiliation:
Service d’Hématologie et d’Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France
Juliette Lambert
Affiliation:
Service d’Hématologie et d’Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
Odile Eloy
Affiliation:
Service de Biologie Médicale, Centre Hospitalier de Versailles, Le Chesnay, France
François Mignon
Affiliation:
Service de Radiologie, Centre Hospitalier de Versailles, Le Chesnay, France
Hassan Farhat
Affiliation:
Service d’Hématologie et d’Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France
Sylvie Castaigne
Affiliation:
Service d’Hématologie et d’Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
Jacques Merrer
Affiliation:
Service de Prévention du Risque Infectieux, Centre Hospitalier de Versailles, Le Chesnay, France
Philippe Rousselot
Affiliation:
Service d’Hématologie et d’Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France Université Versailles Saint-Quentin-en-Yvelines, Versailles, France
*
Address correspondence to Marie-Paule Fernandez-Gerlinger, MD, Unité Mobile de Microbiologie Clinique, Service de Microbiologie, Hôpital européen Georges Pompidou (AP-HP), 20 rue Leblanc, 75015 Paris Cedex, France ([email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE

Invasive aspergillosis (IA) is a rare but severe infection caused by Aspergillus spp. that often develops in immunocompromised patients. Lethality remains high in this population. Therefore, preventive strategies are of key importance. The impact of a mobile air decontamination system (Plasmair, AirInSpace, Montigny-le-Bretonneux, France) on the incidence of IA in neutropenic patients was evaluated in this study.

DESIGN

Retrospective cohort study

METHODS

Patients with chemotherapy-induced neutropenia lasting 7 days or more were included over a 2-year period. Cases of IA were confirmed using the revised European Organization for Research and Treatment of Cancer (EORTC) criteria. We took advantage of a partial installation of Plasmair systems in the hematology intensive care unit during this period to compare patients treated in Plasmair-equipped versus non-equipped rooms. Patients were assigned to Plasmair-equipped or non-equipped rooms depending only on bed availability. Differences in IA incidence in both groups were compared using Fisher’s exact test, and a multivariate analysis was performed to take into account potential confounding factors.

RESULTS

Data from 156 evaluable patients were available. Both groups were homogenous in terms of age, gender, hematological diagnosis, duration of neutropenia, and prophylaxis. A total of 11 cases of probable IA were diagnosed: 10 in patients in non-equipped rooms and only 1 patient in a Plasmair-equipped room. The odds of developing IA were much lower for patients hospitalized in Plasmair-equipped rooms than for patients in non-equipped rooms (P=.02; odds ratio [OR] =0.11; 95% confidence interval [CI], 0.00–0.84).

CONCLUSION

In this study, Plasmair demonstrated a major impact in reducing the incidence of IA in neutropenic patients with hematologic malignancies.

Infect Control Hosp Epidemiol 2016;37:845–851

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 7 , July 2016 , pp. 845 - 851
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

PREVIOUS PRESENTATION. The data from this study were presented at the 25th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) on April 26, 2015, in Copenhagen, Denmark.

References

REFERENCES

1. Gerson, SL, Talbot, GH, Hurwitz, S, Strom, BL, Lusk, EJ, Cassileth, PA. Prolonged granulocytopenia: the major risk factor for invasive pulmonary aspergillosis in patients with acute leukemia. Ann Intern Med 1984;100:345–351.CrossRefGoogle ScholarPubMed
2. Muhlemann, K, Wenger, C, Zenhausern, R, Tauber, MG. Risk factors for invasive aspergillosis in neutropenic patients with hematologic malignancies. Leukemia 2005;19:545–550.CrossRefGoogle ScholarPubMed
3. Segal, BH. Aspergillosis. N Engl J Med 2009;360:1870–1884.Google Scholar
4. Arnow, PM, Sadigh, M, Costas, C, Weil, D, Chudy, R. Endemic and epidemic aspergillosis associated with in-hospital replication of Aspergillus organisms. J Infect Dis 1991;164:998–1002.Google Scholar
5. Berthelot, P, Loulergue, P, Raberin, H, et al. Efficacy of environmental measures to decrease the risk of hospital-acquired aspergillosis in patients hospitalized in hematology wards. Clin Microbiol Infect 2006;12:738–744.CrossRefGoogle Scholar
6. Alberti, C, Bouakline, A, Ribaud, P, et al. Relationship between environmental fungal contamination and the incidence of invasive aspergillosis in hematology patients. J Hosp Infect 2001;48:198–206.CrossRefGoogle Scholar
7. Cornet, M, Levy, V, Fleury, L, et al. Efficacy of prevention by high-efficiency particulate air filtration or laminar airflow against Aspergillus airborne contamination during hospital renovation. Infect Control Hosp Epidemiol 1999;20:508–513.CrossRefGoogle ScholarPubMed
8. Hahn, T, Cummings, KM, Michalek, AM, Lipman, BJ, Segal, BH, McCarthy, PL Jr. Efficacy of high-efficiency particulate air filtration in preventing aspergillosis in immunocompromised patients with hematologic malignancies. Infect Control Hosp Epidemiol 2002;23:525–531.CrossRefGoogle ScholarPubMed
9. Poirot, JL, Gangneux, JP, Fischer, A, et al. Evaluation of a new mobile system for protecting immune-suppressed patients against airborne contamination. Am J Infect Control 2007;35:460–466.CrossRefGoogle ScholarPubMed
10. Sixt, N, Dalle, F, Lafon, I, et al. Reduced fungal contamination of the indoor environment with the Plasmair system (Airinspace). J Hosp Infect 2007;65:156162.CrossRefGoogle ScholarPubMed
11. Gangneux, JP, Robert-Gangneux, F, Gicquel, G, et al. Bacterial and fungal counts in hospital air: comparative yields for 4 sieve impactor air samplers with 2 culture media. Infect Control Hosp Epidemiol 2006;27:1405–1408.CrossRefGoogle ScholarPubMed
12. Bergeron, V, Reboux, G, Poirot, JL, 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.CrossRefGoogle ScholarPubMed
13. Gangneux, JP, Adjide, CC, Bernard, L, et al. Quantitative assessment of fungal risk in the case of construction works in healthcare establishments: Proposed indicators for the determination of the impact of management precautions on the risk of fungal infection [In French]. J Mycol Med 2012;22:64–71.Google Scholar
14. Sautour, M, Sixt, N, Dalle, F, et al. Prospective survey of indoor fungal contamination in hospital during a period of building construction. J Hosp Infect 2007;67:367–373.Google Scholar
15. Pinel, C, Fricker-Hidalgo, H, Lebeau, B, et al. Detection of circulating Aspergillus fumigatus galactomannan: value and limits of the Platelia test for diagnosing invasive aspergillosis. J Clin Microbiol 2003;41:2184–2186.Google Scholar
16. De Pauw, B, Walsh, TJ, Donnelly, JP, 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.CrossRefGoogle Scholar
17. Garnaud, C, Brenier-Pinchart, MP, Thiebaut-Bertrand, A, et al. Seven-year surveillance of nosocomial invasive aspergillosis in a French University Hospital. J Infect 2012;65:559–567.Google Scholar
18. Benet, T, Nicolle, MC, Thiebaut, A, et al. Reduction of invasive aspergillosis incidence among immunocompromised patients after control of environmental exposure. Clin Infect Dis 2007;45:682–686.CrossRefGoogle ScholarPubMed
19. Abdul Salam, ZH, Karlin, RB, Ling, ML, Yang, KS. The impact of portable high-efficiency particulate air filters on the incidence of invasive aspergillosis in a large acute tertiary-care hospital. Am J Infect Control 2010;38:e1–e7.CrossRefGoogle Scholar
20. Munoz, P, Burillo, A, Bouza, E. Environmental surveillance and other control measures in the prevention of nosocomial fungal infections. Clin Microbiol Infect 2001;7(Suppl):2 38–45.CrossRefGoogle ScholarPubMed
21. Bocquet, P, Patris, S, Dumartin, C, Gottot, S, Rykner, G, Brucker, G. The epidemiological surveillance network for nosocomial invasive aspergillosis of the Assistance Publique-Hopitaux de Paris [In French]. Ann Med Interne (Paris)1995;146:79–83.Google Scholar