key: cord-0925473-y8pkieer
authors: Biswal, Manisha; Gupta, Parakriti; Kanaujia, Rimjhim; Kaur, Kulbeer; Kaur, Harsimran; Vyas, Aruna; Hallur, Vinay; Behera, Bijayini; Padaki, Priyadarshini; Savio, Jayanthi; Nagaraj, Savitha; Chunchanur, Sneha K.; JV, Shwetha; R, Ambica; Nagdeo, Neena; Khuraijam, Ranjana; Priyolakshmi, Ningthoujam; Patel, Kamalesh; Thamke, Dipak; Dash, Lona; Jadhav, Duhita; Bharmal, Ramesh; Bhattacharya, Sanjay; Rudramurthy, Shivaprakas M.; Chakrabarti, Arunaloke
title: Evaluation of hospital environment for presence of Mucorales during COVID-19 associated mucormycosis outbreak in India – A multi-centre study
date: 2022-02-03
journal: J Hosp Infect
DOI: 10.1016/j.jhin.2022.01.016
sha: 47fe54b608b46f33e9a8639b2ae1fe173f216fab
doc_id: 925473
cord_uid: y8pkieer

INTRODUCTION: – An unprecedented rise in number of COVID-19 associated mucormycosis (CAM) cases has been reported in India. Myriad hyptheses are proposed for the outbreak. We recently reported uncontrolled diabetes and inappropriate steroid therapy as significant risk factors for the outbreak. However, Mucorales contamination of hospital environment was not studied. We, therefore, planned this multi-centre study across India to determine possible Mucorales contamination of hospital environment during the outbreak. METHODS: Eleven hospitals from four zones of India representing high to low incidence for mucormycosis cases were included in the study. Samples from a variety of equipment used by the patients and ambient air were collected during May 19, 2021 through August 25, 2021. RESULTS: None of the hospital equipment sampled was contaminated with Mucorales. However, Mucorales were isolated from 11.1% air-conditioning vents and 1.7% of patients’ used masks. Other fungi were isolated from 18% hospital equipment and surfaces, and 8.1% used masks. Mucorales grew from 21.7% indoor and 53.8% outdoor air samples. Spore counts of Mucorales in air were significantly higher in the hospitals of North and South zones compared to West and East zones (P< 0.0001). Among Mucorales isolated from the environment Rhizopus spp. were the commonest genus. CONCLUSION: – We found contamination of air-conditioning vents and hospital air by Mucorales. Presence of Mucorales in these areas demands regular surveillance and improvement of hospital environment, as contamination may contribute to healthcare associated mucormycosis outbreaks, especially among immunocompromised patients.

During the COVID-19 pandemic an unprecedented rise in number of mucormycosis cases has 52 been reported in India [1] . Government 

Epidemiology, clinical 254 profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral 255 mucormycosis in 2826 patients in India -Collaborative OPAI-IJO Study on

Recovery of 299 filamentous fungi from water in a paediatric bone marrow transplantation unit