Indoor Air Contamination by Yeasts in Healthcare Facilities: Risks of Invasive Fungal Infection

J. P. M. do Nascimento, Raniele dos Santos, Mirna Samile dos Santos Silva, Mykaella Andrade de Araújo, Lucas Anhezini, Daniela Évelin dos Santos, E.A. Da Silva‐Filho
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Abstract

Introduction-Aims: Fungi are ubiquitous microorganisms that are easily dispersed through the air. In healthcare environments, indoor air can favor the spread of healthcare-associated fungal infections, compromising mainly immunocompromised hospitalized individuals. Therefore, this study aimed to evaluate indoor air contamination in healthcare environments, investigating mainly the presence of potentially pathogenic yeasts. Method: Indoor air samples were collected from 12 healthcare environments (hospital and medical clinics). After the growth, isolation, and purification of the yeast colonies, the isolates were identified by polymerase chain reaction using species-specific primers for yeasts of the genus Candida and sequencing of D1/D2 domains of the large ribosomal subunit (LSU rRNA). Results and interpretation: Fourteen yeast species were identified, including emerging pathogens. Species of clinical importance such as Candida parapsilosis, Candida glabrata, and Rhodotorula mucilaginosa were present. C. parapsilosis was the most prevalent species, followed by Rhodotorula mucilaginosa. In addition, we report the first occurrence of Candida orthopsilosis, Trichosporon mucoides, Fereydounia khargensis, and Hortaea werneckii in indoor air samples collected in healthcare environments. The present study shows that potentially fungal pathogens were present in air samples from healthcare environments, proving the role of indoor air in spreading infections. Therefore, monitoring air quality in healthcare environments is a fundamental approach to developing infection control measures, especially those related to invasive fungal infections.
医疗设施中酵母菌的室内空气污染:侵袭性真菌感染的风险
目的:真菌是普遍存在的微生物,很容易通过空气传播。在卫生保健环境中,室内空气有利于卫生保健相关真菌感染的传播,主要危害免疫功能低下的住院患者。因此,本研究旨在评估医疗环境中的室内空气污染,主要调查潜在致病性酵母菌的存在。方法:采集12个卫生保健环境(医院和诊所)的室内空气样本。在酵母菌落的生长、分离和纯化后,利用念珠菌属酵母的物种特异性引物进行聚合酶链反应鉴定,并对大核糖体亚基(LSU rRNA)的D1/D2结构域进行测序。结果和解释:鉴定出14种酵母菌,包括新出现的病原体。有临床意义的种类,如假丝酵母菌、光秃假丝酵母菌和粘液红酵母。其次是粘红曲菌(Rhodotorula mucilaginosa)。此外,我们报告了在卫生保健环境中收集的室内空气样本中首次出现念珠菌矫形丝孢菌、粘液毛孢菌、哈尔根氏Fereydounia和werneckii。目前的研究表明,潜在的真菌病原体存在于医疗环境的空气样本中,证明室内空气在传播感染中的作用。因此,监测医疗环境中的空气质量是制定感染控制措施的基本方法,特别是与侵袭性真菌感染有关的措施。
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