ASPERGILLOSIS CONTAMINATION - EVALUATION OF PREVENTIVE MEASURES AND ENVIRONMENT SURVEILLANCE

Aspergillosis has become a major fungal infection in hospitals since t he advent of immunosuppressive therapy in the last fifteen years. Aspe rgilli are saprophytic and ubiquitous fungi and are associated with pu lmonary and disseminated infections in immunodepressed patients with a mortality rate of about 85 %. Aspergillosis is an air-borne infection , thus intensive care units should be conceived so as to decrease the outer risk of contamination. In the first part of this chapter the con ception of such a unit is presented, taking the bone marrow transplant ation unit of St-Louis Hospital as an example. A prospective study of the quality of the environment is a complementary and necessary inform ation. In the second part of this chapter, the methods of airborn cont rol of Aspergillus sp. are investigated. According to the literature, commun concepts can be drawn to evaluate nosocomial risks of aspergill osis. Nevertheless in the absence of a defined and accepted methodolog y, it is not possible up to that date to propose norms and acceptable norms of levels of contamination adapted to the degree of immunodepres sion of patients.