Surveillance Using the Aspergillus Antigen Test During Construction in a Hospital

TERADA Kihei, KUROKAWA Yukinori

doi:10.11550/jsei1986.21.175

Cases of invasive aspergillosis are reported to increase during construction work in a hospital. Our hospital underwent reconstruction beginning in December 2002, so we investigated good surveillance methods for the prevention of invasive aspergillosis. The first trial surveyed the positive rate in the serum aspergillus antigen test among samples. Positive rate had been less than 4% from the first half of 1999 to the first half of 2002, but increased to 7.6% in the second half of 2002 and 14.3% in the first half of 2003. However, the positive rate among immunocompromised patients apparently did not increase. The sensitivity of test increased in September 2002, as the method was changed from agglutinin assay to ELISA. Therefore, the change of assay was thought to be the reason for the increase. The second trial excluded multiple samples from the same patient to investigate the positive rate among patients. The positive rate increased to 6.3% in early half of 2005 from 3.5% in the first half of 2004 and 3.2% in the second half of 2004. We found the number of positive patients increased in the wards, in particular in the division of hematology. The increase in positive patients coincided with the transfer of clean rooms to a new ward. Therefore, we suspected this operation to be the cause. Fortunately, no patients with invasive aspergillosis were found, but positive findings were limited to terminal malignancy patients in the wards. Thereafter, we established guidelines and a new manual for prevention of invasive aspergillosis. Surveillance based on the serum antigen test is one of the best methods for prevention.

Surveillance Using the Aspergillus Antigen Test During Construction in a Hospital

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