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Prévention, contrôle et maîtrise du risque d’aspergillose invasive au Groupement Hospitalier Edouard Herriot lors de travaux : apport de la surveillance et de l’alerte environnementale et épidémiologique

Sophie Loeffert 1
1 LPE-Fondation Mérieux - Laboratoire des pathogènes émergents -- Emerging Pathogens Laboratory
CIRI - Centre International de Recherche en Infectiologie - UMR
Abstract : Invasive aspergillosis (IA) due to Aspergillus has been associated with building construction, which may increase spores emission nearby immunocompromised patients. In 2015, one blocks of 6,000 m2 (60 beds) form our hospital has been entirely demolished. The aim of this study was to evaluate possible association between concentration of A. fumigatus (AF) spores in the outdoor and indoor environment and also with the clinical cases in order to propose some improvements in actuals methods and practices. A daily surveillance of fungal contamination was implemented during 11-months. Environmental survey was realized by air samplings, outdoor and indoor, with an automatic agar sampler. In parallel, surveillance of IA infection cases was conducted by epidemiological investigation. A total of 3885 air samples (1744 outdoor samples and 2141 indoor samples) were collected, allowing calculation of ratios (outdoor vs indoor) to confirm efficacy of preventives measures applied to reduce indoor aerocontamination. Outdoor continuous sampling of Aspergillaceae spores (spore/m3/day) was also realized by a Hirst collector. This collector was useful as alarm system to detect contamination peaks. Similarly, monitoring of meteorological parameters seems to be an interesting tool, to prevent Aspergillus peaks. Finally, 394 isolates of AF, susceptible to antifungals (383 environmental and 11 clinical isolates) were genotyped using MLVA. Analysis of genotypes showed 7 similar genotypes shared by environmental and clinical isolates, suggesting that clinical colonization and/or infection may originate from the hospital environment
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https://tel.archives-ouvertes.fr/tel-01782407
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Submitted on : Wednesday, May 2, 2018 - 9:10:08 AM
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  • HAL Id : tel-01782407, version 2

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Sophie Loeffert. Prévention, contrôle et maîtrise du risque d’aspergillose invasive au Groupement Hospitalier Edouard Herriot lors de travaux : apport de la surveillance et de l’alerte environnementale et épidémiologique. Ecologie, Environnement. Université de Lyon, 2017. Français. ⟨NNT : 2017LYSE1246⟩. ⟨tel-01782407v2⟩

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