医院建筑施工期间曲霉菌污染及预防措施效果（翻译有奖）

潮水

Airborne Aspergillus contamination during hospital construction works: Efficacy of protective measures
American Journal of Infection Control
Volume 38, Issue 3, Pages 189-194 (April 2010)
Background
The Dijon University Hospital in Dijon, France is involved in a large construction program with heavy truck traffic and a very dusty environment. This study aimed to assess the impact of outdoor hospital construction work on Aspergillus air contamination in the immediate environment of patients at high risk for aspergillosis in the presence of protective measures.

Methods
Prospective air and surface sampling (n=1301) was performed in 3 hospital units over a 30-month period. Generalized estimating equations were used to test the relationship between Aspergillus air contamination and the different variables (construction period, air treatment system, and surface contamination).

Results
Positivity rates of Aspergillus spp varied from 21.1% before construction work to 16.9% during work for air samples (P=.07), and the associated mean fungal load varied from 1.21 colony-forming units (CFU)/m3 to 0.64 CFU/m3 (P=.04). In multivariate analysis, only the use of an air treatment system was associated with decreased airborne Aspergillus contamination (P < .0001). No significant difference was observed between the presence or absence of construction work and the proportion of airborne Aspergillus contamination (P=.91) or the Aspergillus fungal load (P=.10).

Conclusions
No influence of hospital construction work on airborne Aspergillus contamination was demonstrated when protective measures were taken, including reinforcement of the importance of environmental cleaning.

Key Words: Aspergillus, hospital, air treatment, airborne contamination, building construction, protective measures

wjllulu

背景：法国第戎大学医院参与了一个大型建筑项目，施工期间有重型卡车穿梭和产生多尘的环境。本研究目的旨在评估施行防护措施的情况下，医院附近的建筑工场对医院空气（曲菌高风险病人的环境）曲霉菌污染的影响。
    方法：在30个月的建筑施工期，对3所医院进行了前瞻性空气和物表采样共1301份。用总体估计方法，测试曲霉菌空气污染和不同的变量（施工期间、使用空气处理措施及物体表面污染情况）之间的关系。
    结果：空气采样中曲霉菌阳性率为建筑施工前21.1%，施工期为16.9%（P =0. 7）。相关的真菌负荷平均从1.21至0.64（CFU）/立方米不等（P =0. 04）。在多变量分析中，只有使用空气处理措施后与降低空气曲霉污染相关系（P <.0001）。而有无施工的情况对空气中曲菌污染比率无显著性差异（P =0. 91），对曲霉真菌污染载荷数量（也无显著性差异）（P =0. 10）。
    结论：如果实施防护措施，如加强环境卫生清洁后，未发现医院建筑工地对医院空气中曲霉污染的（差异）影响。

潮水

国外文献多次报道医院建筑施工期间曲霉菌感染爆发事件，看来实施环境卫生防控措施对曲霉菌污染影响较大。

四叶草

很想知道，当医院有施工的时候，病房，特别是重点保护的患者病房该如何预防？