Surveillance of Fungal Airborne Contamination in Hospital Wards in Indonesia 2020-2021: Impact of HEPA Filters and Occupancy

Background: Airborne biological agents in hospitals, such as fungal micro-colonies, play a significant role in life-threatening airborne infections in immunocompromised individuals. Thus, it is crucial to reduce airborne contamination and address the related influencing factors. This study aimed to evaluate indoor air quality (IAQ) in terms of fungal contamination and factors that could influence IAQ in hospital rooms.. Materials & Methods: This environmental surveillance study was conducted in two rooms for one year, and 288 air specimens were collected using the active air sampling method equipped with chloramphenicol-supplemented Sabouraud dextrose agar. Temperature, relative humidity, and occupants’ number were also recorded. Fungal colony counts were recorded and converted using the Feller table. Furthermore, fungi were identified based on macroscopic and microscopic characteristics. Findings: The mean difference of isolated fungi between the two rooms was statistically significant (p<.0001). Yeast, Penicillium spp, and Aspergillus spp. were the most predominant fungi. Both rooms had temperature and relative humidity above the national recommended levels (above 23 ˚C and %60). Occupants’ number in the room without HEPA filter was significantly correlated with airborne fungal contamination level. Conclusion: The level of airborne fungal contamination was significantly higher in the room without a HEPA filter. Yeast, Aspergillus spp., and Penicillium spp. were the most predominant fungi isolated from both rooms. Room temperature and relative humidity had no effect on airborne fungal contamination level. Occupants’ number in the room without HEPA filter influenced airborne fungal contamination level.