Model of an Aspergillosis Surveillance Program in an Urban Academic Acute Care Hospital

Document Type

Conference Proceeding

Publication Date

6-1-2025

Publication Title

Am J Infect Control

Abstract

Background: Healthcare-Acquired Aspergillosis (HAA) contributes to both prolonged hospital stay and potentially fatal infections for certain populations. Timely diagnosis of HAA can identify potential issues with healthcare facility water management processes and infection control (IC) risk assessment in construction activities. We sought to describe a model for implementation of an aspergillus surveillance system at our 877-bed tertiary care academic hospital which houses severely immunosuppressed patients in an aging infrastructure. Methods: IC specialist partnered with infectious disease (ID) physicians to define HAA and risks factors for invasive infection using established case definitions from Centers for Disease Control and Prevention (CDC). Patients were screened through electronic medical record for positive fungal cultures for Aspergillus, as well as positive fungal markers (serum, respiratory). Risk factors were compiled for tracking and analysis. Clinical variables included patient demographics, source, type of specimen and test, risk factors (i.e., underlying lung conditions, immunosuppression, coronavirus disease and influenza test results within 21 days prior positive aspergillus result), antifungal treatment, and IC construction risk assessment, leak, and water testing reports. Results: Analysis revealed 86 positive cases from January-October 2024 from blood and respiratory sources, 35% of the positive cases were immunocompromised. 51% were through fungal markers, 49% were culture-based. 11% required treatment with antifungal therapy.14% were admitted to the hospital for >7 days prior to positive test collection date. One case (1.2%) was found to be HAA using CDC case definitions. An on-going review and monitoring of relevant construction practices and water surveillance programs did not identify environmental contamination and gaps in water management processes. Conclusions: We present a collaborative model for IC specialist and ID physicians to carefully monitor positive Aspergillus cases for early identification of HAA and the opportunity to keenly evaluate potential environmental issues in construction and water management programs in an aging hospital infrastructure.

Volume

53

Issue

6

First Page

S34

Last Page

S35

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