nosocomial infection (Hospitals )

[Guest guest]

I was asked to investigate a hospital in London where two children died of

aspergillosis. They were in a ward awaiting organ transplant and were immune

compromised from taking pre op organ rejection drugs. The hospital was

filthy and a fool could see the problems. Another hospital helping a friend

with cystic fibrosis had a side room with a relative humidity of 84% and was

expected to die at the late age of 28 from aspergillosis. (Usual cause of

death for CF sufferers) I reduced humidity installed an ultra violet at C

wavelength coupled to Hepa filtration. This was the first time in his 29

years that he had left hospital with no aspergillus in his sputum.

The parents were not told the real cause of death of the infants.

Jeff Charlton

In London

00 44 (0)8700 789 999

http://rockymountainnews.com/drmn/state/article/0,1299,DRMN_21_343369

6,00.html

VA cites cleanliness problem at hospital

Officials say fungal infections may be linked to dirt floor

By Ann Imse, Rocky Mountain News

December 30, 2004

At least one patient has died at the Veterans Affairs Medical Center

in Denver from a fungal infection that may have originated in a dirt-

floor subbasement in the 53-year-old building, the chief of staff

said Wednesday.

Six chemotherapy patients became infected with the aspergillus

fungus in the last 2 1/2 years and " some died, including the last

one " in May, said Dr. Leigh . The hospital was unable to

ascertain late Wednesday exactly how many veterans succumbed.

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The hospital has been diverting its chemotherapy patients to

University Hospital for much of that period as a result,

said.

The aspergillus infections were among a number of issues cited in a

Department of Veterans Affairs inspection of the hospital released

on Monday.

The inspection, conducted last June, also found bathrooms,

outpatient clinics, nurses stations and other areas to be simply

dirty. In two surveys, 54 percent to 74 percent of the staff said

they found " inadequate cleanliness throughout the facility. "

said the hospital is spending hundreds of thousands of

dollars on more frequent cleaning and on several refurbishment

projects to solve the problems. A reinspection in August

found " aggressive " action by the hospital to correct the issues, the

report said.

attributed the cleanliness problem to Congress' decision to

offer VA care to more veterans without providing adequate funding.

The hospital hired extra staff to care for the additional patients,

and paid for it by cutting back the cleaning of nonpatient areas, he

said.

blamed the dirt in the bathrooms on their constant use and

said the hospital now cleans them repeatedly each day.

added that the hospital's overall infection rates have

declined, indicating the areas affecting patient care have remained

clean.

But the aspergillus fungus problem was another story.

Its source remained elusive for two years, despite repeated biocide

scrubbings of the ventilation system.

The fungus is common, lives in the soil and is dormant until it

becomes damp. It is readily fought off by a healthy person, but it

can kill half the chemotherapy and transplant patients it infects

because their immune systems are so suppressed, said.

Five chemotherapy patients became infected in May and June of 2002.

The hospital considered outside sources for the infections,

including forest fire smoke that covered Denver for several days

that year. But the first cluster of cases were " most probably "

acquired in the hospital, the inspection report said.

Officials stopped accepting chemotherapy clients for more than a

year as it searched and scrubbed the air ducts, said. The

chemotherapy unit reopened in August of last year.

Then another patient came down with the infection in May and died,

said.

Hospital officials finally determined that a water main break a

month earlier in the hospital's subbasement might be connected.

Aspergillus spores were subsequently found in the subbasement's dirt

floor. They could have revived in the damp and floated up an

elevator shaft, said, and might have been the source of the

hospital patient's infection.

To ensure the hospital's safety, officials are planning an expensive

remodeling, which includes venting the subbasement and preventing

its air from moving up the elevator shaft.

One intensive care room and four oncology rooms also will be

switched to positive air pressure to keep infectious agents out,

said.

The remodeling will be done even though the outmoded hospital is

scheduled for closure after a replacement is built. A new hospital

is planned for the Fitzsimons campus in Aurora as soon as 2007.

In the meantime, the hospital is again sending its chemotherapy

patients elsewhere at a cost of $1 million a year.

" It's a lot of work, but it's the only way we can make it safe for

our patients. It's because it's an old building, " he said.

" Dealing with an open-dirt subbasement is not something they taught

me in medical school, " he added.

said the influx of patients is causing other problems for

the VA hospital, particularly since it is occurring during a

national shortage of nurses.

The hospital has had to cancel numerous elective surgeries to make

room for emergencies in the past year. But that problem has been

eased by actions to shorten hospital stays and prevent outpatients

from needing overnight care, he said.

Aspergillus facts

.. Aspergillus is a group of molds that occur worldwide.

.. Only a few of these molds can cause illness.

.. Most people are naturally immune and do not develop diseases

caused by Aspergillus.

.. In people with poor immune systems, the fungus can transfer from

the lungs through the blood to the brain or other organs.

Source: Fungal Research Trust

imsea@... or 303-892-5438

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