Fungal Air Quality in Medical Protected Environments

Abstract

Fungi are ubiquitous in indoor environments and are responsible for a wide range of diseases, from localized non-invasive pathologies to invasive and disseminated infections. These infections occur predominantly among highly immunosuppressed patients (patients with acute leukaemia, haematopoietic stem cell or solid organ transplantation) and can have devastating consequences. Aspergillus remains the most common mould to cause invasive infections, but other fungi are emerging as serious pathogens and threats in immunosuppressed patients. Most invasive fungal infections are acquired from air. It is therefore imperative to adopt, in clinical environments, preventive measures in order to reduce airborne fungal concentrations and, concomitantly, the risk for development of a fungal infection. At present, there are no methods and equipments that can completely eliminate fungi from indoor medical environments. Exposure to moulds in medical units is inevitable but the presence of air filtration systems, isolation, and adoption of environmental protective measures do mitigate patient exposure. Airborne mycological investigations should inform about indoor air quality and therefore should be routinely carried out in hospitals or other institutions where immunosuppressed individuals are treated. It is important to improve the methods already available to study indoor fungi in clean environments, and it is critical to define indicators of indoor air quality in medical environments. The present chapter deals with the biology of indoor fungi in medical environments, and the strategies and technical progresses that are at present available to prevent and control fungal diseases and to improve air quality in medical facilities.