Raposo Puglia, D.; Raposo Puglia, J.Á.; García-Cabrera, E.; Morales, F.; Camacho-Vega, J.C.; Vilches-Arenas, Á. Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies. Clin. Pract.2024, 14, 280-292.
Raposo Puglia, D.; Raposo Puglia, J.Á.; García-Cabrera, E.; Morales, F.; Camacho-Vega, J.C.; Vilches-Arenas, Á. Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies. Clin. Pract. 2024, 14, 280-292.
Raposo Puglia, D.; Raposo Puglia, J.Á.; García-Cabrera, E.; Morales, F.; Camacho-Vega, J.C.; Vilches-Arenas, Á. Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies. Clin. Pract.2024, 14, 280-292.
Raposo Puglia, D.; Raposo Puglia, J.Á.; García-Cabrera, E.; Morales, F.; Camacho-Vega, J.C.; Vilches-Arenas, Á. Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies. Clin. Pract. 2024, 14, 280-292.
Abstract
Background Aspergillus spp. is a widely distributed filamentous fungus in the environment due to its high sporulation capacity. Currently, invasive aspergillosis (IA) is the most common invasive fungal infection in patients with hematologic malignancies with high rates of mortality and morbidity. The multifactorial nature of the disease requires appropriate risk stratification to allow the most appropriate preventive measures to be adapted and implemented according to the characteristics of the patient. In this sense, the present research aims to identify recent risk factors and environmental control measures against invasive aspergillosis to establish preventive actions to reduce the incidence of invasive aspergillosis in hospitals; (2) Methods: We conducted a qualitative systematic review of the scientific literature on environmental risk factors and preventive measures for invasive aspergillosis in patients with hematological malignancies. The Medline, Cochrane and Scopus databases were consulted, following the PRISMA and STROBE guidelines; (3) Results Adequate implementation of environmental control measures is presented as the most efficient intervention in terms of prevention to decrease the incidence of invasive aspergillosis in hospitals. We identify neutropenia, fungal contamination, lack of adequate environmental control measures in hospitals and patients´ homes, duration of hospitalization, and anemia as independent risk factors. We show that HEPA, LAF and Plasmair® systems are suitable methods to reduce the concentration of airborne fungal spores. Antifungal prophylaxis did not influence the reduction of IA significantly in our study; (4) Conclusions: Proper professional training and environmental control measures in hospitals are essential for the prevention of invasive aspergillosis. We should optimize risk stratification for patients with hematologic malignancies. Antifungal prophylaxis should be complementary to environmental control measures and should never be substituted for these last ones. Studies should also be done to evaluate the efficiency of environmental control measures against IA at patients' homes.
Public Health and Healthcare, Public, Environmental and Occupational Health
Copyright:
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