P154 Fungal spore count in a tertiary care hospital in Mumbai, India

POSTER SESSION 2, SEPTEMBER 22, 2022, 12:30 PM - 1:30 PM: OBJECTIVES: Fungal spores are ubiquitously present in the environment. Appropriate temperature and humidity can lead to fungal growth. It is of concern in a hospital environment. Diabetic and immunosuppressed persons are more vulnerable to such infections. The fairly humid and slightly warm climate of Mumbai is ideal for fungal growth. According to an article released in March 2021, the total fungal count in Mumbai was 16.2 CFUs. Here is a brief gist of how fungal spores were controlled within a tertiary hospital in Mumbai, India which is located near sea by simple but effective methods. METHODS: Air sampling of the Operation Theatre (OT), Central Sterile Supply Department (CSSD), Bone marrow transplant (BMT) areas is done on weekly basis in the hospital and for areas such as ICU (Intensive Care Unit), Oncology (ONCO) Ward, Cardiac Catheterization (Cath) lab and Digital subtraction angiography (DSA) lab monthly air sampling is done to check for bacterial and fungal load. Two types of air samplers are used: Heico air sampler from HiMedia and Dyanamicro air sampler. OT, BMT, CSSD have HEPA (high efficiency particulate air) filters installed for filtration of air. The other areas like ICU, ONCO ward, Cath lab, and DSA lab do not have HEPA filters. RESULTS: In the last 4 years there were two instances where fungal growth was observed once in BMT and once in ICU. In ICU Aspergillus niger growth was observed and in BMT there was a growth of multiple Aspergillus spp. It took nearly 3-4 months for the eradication of the fungus in BMT and 2 months to clear the fungus from ICU. Due to strict engineering control, we were able to restrict the spread within hospital. In BMT unit the growth was observed during rainy season when because of heavy rain there was seepage in one wall of the unit and also there was a leakage of sink in the ante-room area. When these repairs were done the fungal growth was not observed afterward. In ICU thorough cleaning of the Air Handling Unit (AHU) filter leads to resolution of the issue. Both these episodes were uneventful as no patient had any infection due to these. Factors that helped in controlling the fungal spores spread are: Controlled temperature. Humidity. AC duct cleaning. Regular AHU filter cleaning. Different sizes of filters used for filtration of circulating air in hospital. Number of air changes. Use of antifungal paints in the hospital. Regular checks in hospital for any leakage or seepage issues. Monitoring of constructional activities in the hospital with appropriate measures to control fungal spore dissemination. CONCLUSION: Even though the hospital is situated near sea and the outside air has high humidity and high microbial load, effective engineering measures and close monitoring of the areas can help in controlling the spread of fungus within the hospital. Routine periodic checks of the air for fungal spores can also help prevent nosocomial infections.