Nosocomial aspergillosis and building construction.

Healthcare-associated infections (HAI) with Apergillus pose a serious threat to those most severely immune suppressed patients. Outbreaks of nosocomial aspergillosis have occurred mainly among neutropenic patients, but with several important exceptions. HAI due to aspergillosi has occurred in association with environmental disturbances including but not limited to: hospital construction, maintenance, demolition and renovation; contaminated fireproofing materials; air filters in hospital ventilation systems, and via contaminated carpeting. It behooves those in the practice of patient care to prevent these situations before they occur, as opposed to dealing with them once they happen. The framework of the six links in the infectious disease process will be used to examine healthcare-associated invasive aspergillosis: causative agent, portal of entry, susceptible host, portal of exit, reservoir and mode of transmission. Two particular interventions: the Protective Environment (PE), and the Infection Control Risk Assessment (ICRA), will be outlined. Building construction projects and the number of neutropenic patients are likely to continue to increase. Therefore, future directions need to focus on reducing the susceptibility of the susceptible host and reducing the exposure to Aspergillus from environmental sources. In addition, recently released guidelines with control measures aimed at reducing environmental exposure to Aspergillus need to be further studied.