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New draft guidance published on aspergillosis prevention

The Aspergillosis Sub-Committee of the Health Protection Surveillance Centre (HPSC) Scientific Advisory Committee has prepared  draft Guidelines for the Prevention of Nosocomial Invasive Aspergillosis, which will update the current 2002 document. The draft guidance is available on the HPSC website (www.hpsc.ie), with a deadline of 20 May 2016 for submission of comments.

Aspergillus may be released into the air during construction or renovation activities.

In February, the Medical Independent (MI) reported that aspergillus was identified in the General ICU at Beaumont Hospital, Dublin, in July 2015. Hospital renovations were ongoing during this time. “Two patients were treated as possible cases [of infection], as per the Irish and European guidelines. Following a risk assessment, no patients required follow-on treatment,” said the hospital’s spokesperson.

Despite advances, IA remains difficult to diagnose and treat, and case fatality associated with IA remains high, says the HPSC’s draft guidance.

The draft guidance notes that IA is primarily an infection of severely immunocompromised patients. However, it reports that it is increasingly recognised that patients who are not immunocompromised, but who are critically ill or have severe COPD, are at increased risk.

The issue of ‘aspergillus control’ has been noted in a number of HIQA inspections of hospitals.

HIQA found “deficiencies” in aspergillus control at Kerry General Hospital during an August 2015 inspection. Dust control measures were not in place “during dust-generating renovation works in progress on a corridor leading to the Oncology Day Unit”.

During an inspection of Letterkenny General Hospital in June 2015, when “extensive building works” were underway, the Authority was “not assured” that the risk of IA was being “fully managed in line with the infection prevention and control standards”.

There were no staff training records or patient information leaflets regarding aspergillus control provided at the time of the inspection or at the re-inspection in July.

The Authority’s report on an unannounced inspection of Beaumont Hospital in August 2015 carried no reference to aspergillus control.

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