Fungal reservoirs in the hospital environment: prevalence and factors associated with Aspergillus contamination of bed rails in a tertiary hospital in Nigeria

Olufunmilola MakanjuolaDepartment of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria; 2Department of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeriahttps://orcid.org/0000-0001-7785-0183

Gloria IgborDepartment of Biomedical Laboratory Science, College of Medicine, University of Ibadan, Ibadan, Nigeria

Florence BamigbolaDepartment of Medical Microbiology and Parasitology, University College Hospital, Ibadan, Nigeria; and Department of Biomedical Laboratory Science, College of Medicine, University of Ibadan, Ibadan, Nigeria

DOI:

https://doi.org/10.3396/ijic.v22.23864

Keywords:

Aspergillus flavus, Aspergillosis, invasive fungal infections, healthcare associated infections, infection control

Abstract

Background: Aspergillus species are common environmental fungi known to cause Aspergillosis, often presenting as an invasive infection in individuals with a compromised immune system. It is transmitted by the inhalation of Aspergillus spores and contributes to healthcare associated infections in hospitalised patients. Since these patients spend most of the day in their hospital beds, the presence of Aspergillus spores in such settings puts the patient at risk of inhaling aerosolised spores leading to infections.

Objective: To determine the prevalence, distribution, and factors associated with Aspergillus contamination of hospital bed rails.

Design: This laboratory-based cross-sectional study was carried out at the University College Hospital, Ibadan, Southwest Nigeria, between May and June 2023. In all, 100 beds which were occupied by patients in 13 wards were included in this study. The left and right rails of beds were swabbed and processed for the detection of Aspergillus species using fungal culture and microscopy. A checklist was used to assess selected infection prevention and control measures in the wards.

Results: The total number of bedrails with Aspergillus isolated across all the wards where samples were taken was 56 (28.0%). Aspergillus niger was the most prevalent specie (64.2%) followed by Aspergillus flavus (30.4%), then Aspergillus fumigatus (5.4%). The prevalence of Aspergillus contamination was related to the level of sanitation and proximity to construction activity.

Conclusion: To reduce the risk of Aspergillus infections in hospitalised patients, adequate infection prevention and control measures including thorough cleaning and disinfection should be strictly adhered to.

How to Site:

Makanjuola, O., Igbor, G., & Bamigbola, F. (2026). Fungal reservoirs in the hospital environment: prevalence and factors associated with Aspergillus contamination of bed rails in a tertiary hospital in Nigeria. International Journal of Infection Control, 22. https://doi.org/10.3396/ijic.v22.23864

References

1. Khan A, Baig K, Mehboob R. Nosocomial Infections: epidemiology, prevention, control and surveillance. Asian Pac J Trop Biomed 2017; 7(5): 478–82. doi: 10.1016/j.apjtb.2017.01.019

2. WHO report on the burden of endemic health care-associated infection worldwide. Geneva: World Health Organization; 2011, pp. 1–40. Available from: https://www.who.int/news-room/feature-stories/detail/the-burden-of-health-care-associated-infection-worldwide [cited 21 March 2023].

3. Eames I, Tang JW, Li Y, Wilson P. Airborne transmission of disease in hospitals. J R Soc Interface 2009; 6(6): S697–702. doi: 10.1098/rsif.2009.0407

4. Castón-Osorio JJ, Rivero A, Torre-Cisneros J. Epidemiology of invasive fungal infection. Int J Antimicrob Agents 2008; 32(2): S103–9. doi: 10.1016/S0924-8579(08)70009-8

5. Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011; 377(9761): 228–41. doi: 10.1016/S0140-6736(10)61458-4

6. Loeffert S, Hénaff L, Dupont D, Bienvenu A, Dananché C, Cassier P, et al. Prospective survey of azole drug resistance among environmental and clinical isolates of Aspergillus fumigatus in a French University hospital during major demolition works. J Mycol Med 2018; 28: 469–72. doi: 10.1016/j.mycmed.2018.05.007

7. Warris A, Verweij E. Clinical implications of environmental sources for Aspergillus. Med Mycol 2005; 43(1): 859–65. doi: 10.1080/13693780400025260

8. Iyalla C. Spectrum of aspergillosis: pathogenesis, risk factors and management. Afr J Clin Exp Microbiol 2016; 17(1): 35–45. doi: 10.4314/ajcem.v17i1.5

9. Maschmeyer G, Haas A, Cornely OA. Invasive aspergillosis: epidemiology, diagnosis and management in immunocompromised patients. Drugs 2007; 67(11): 1567. doi: 10.2165/00003495-200767110-00004

10. Paulussen C, Hallsworth JE, Álvarez-Pérez S, Nierman WC, Hamill PG, Blain D, et al. Ecology of aspergillosis: insights into the pathogenic potency of Aspergillus fumigatus and some other Aspergillus species. Microb Biotechnol 2017; 10(2): 296–322. doi: 10.1111/1751-7915.12367

11. Karalti I, Colakoglu T. Isolation and Identification of Aspergillus species during one year in the hospitals. J Life Sci 2012; 6: 1220–4.

12. Diba K, Kordbacheh P, Mirhendi S, Rezaie S, Mahmoudi M. Identification of Aspergillus species using morphological characteristics. Pak J Med Sci 2007; 23: 867–72.

13. Sugui JA, Kwon-Chung KJ, Juvvadi PR, Latgé JP, Steinbach WJ. Aspergillus fumigatus and related species. Cold Spring Harb Perspect Med 2014; 5(2): a019786. doi: 10.1101/cshperspect.a019786

14. Diba K, Jangi F, Makhdoomi K, Moshiri N, Mansouri F. Aspergillus diversity in the environments of nosocomial infection cases at a university hospital. J Med Life 2019; 12(2): 128–32. doi: 10.25122/jml-2018-0057

15. Howel SA, Hazen KC, Brandt ME. Manual of clinical microbiology. 11th ed. Washington, DC: ASM Press; 2015.

16. Seagle EE, Williams SL, Chiller TM. Recent trends in the epidemiology of fungal infections. Infect Dis Clin North Am 2021; 35(2): 237–60. doi: 10.1016/j.idc.2021.03.001

17. Pal M, Dave P, Manna A. Emerging role of Aspergillus flavus in humans and animal disorders. J Mycopath Res 2014; 52(2): 211–6.

18. Perlroth J, Choi B, Spellberg B. Nosocomial fungal infections: epidemiology, diagnosis and treatment. Med Mycol 2007; 45(4): 21–46. doi: 10.1080/13693780701218689

19. Jangi F, Makhdoomi K, Moshiri N, Diba K, Mansouri F. Aspergillus diversity in the environments of nosocomial infection cases at a university hospital. J Med Life 2019; 12(2): 128–32. doi: 10.25122/jml-2018-0057

20. Martínez-Herrera EO, Frías De-León MG, Duarte-Escalante E, Calderón-Ezquerro MDC, Jiménez-Martínez MDC, Acosta-Altamirano G, et al. Fungal diversity and Aspergillus in hospital environments. Ann Agric Environ Med 2016; 23(2): 264–9. doi: 10.5604/12321966.1203888

21. Curtis L, Cali S, Conroy L, Baker K, Ou CH, Hershow R, et al. Aspergillus surveillance project at a large tertiary-care hospital. J Hosp Infect 2005; 59(3): 188–96. doi: 10.1016/j.jhin.2004.05.017

22. Person AK, Chudgar SM, Norton BL, Tong BC, Stout JE. Aspergillus niger: an unusual cause of invasive pulmonary aspergillosis. J Med Microbiol 2010; 59(7): 834–8. doi: 10.1099/jmm.0.018309-0

23. Rudramurthy SM, de Valk HA, Chakrabarti A, Meis JFGM, Klaassen CHW. High resolution genotyping of clinical aspergillus flavus isolates from india using microsatellites. PLoS One 2011; 6(1): e16086. doi: 10.1371/journal.pone.0016086

24. Hicks JB, Lu ET, De Guzman R, Weingart M. Fungal types and concentrations from settled dust in normal residences. J Occup Environ Hyg 2005; 2(10): 481–92. doi: 10.1080/15459620500252860

25. Parveen S, Wani AH, Shah MA, Devi HS, Bhat MY, Koka JA, et al. Preparation, characterization and antifungal activity of iron oxide nanoparticles. Microb Pathog 2018; 115: 287–92. doi: 10.1016/j.micpath.2017.12.068

26. Anaissie E, Stratton S, Dignani M. Cleaning patient shower facilities: a novel approach to reducing patient exposure to aerosolized Aspergillus species and other opportunistic moulds. Clin Infect Dis 2002; 35(8): E86–8. doi: 10.1086/342305

27. Cooper E, O’Reilly M, Guest D, Dharmage S. Influence of building construction work on Aspergillus infection in a hospital setting. Infect Control Hosp Epidemiol 2003; 24(7): 472–6. doi: 10.1086/502239

28. Kanamori H, Rutala WA, Sickbert-Bennett EE, Weber DJ. Review of fungal outbreaks and infection prevention in healthcare settings during construction and renovation. Clin Infect Dis 2015; 61: 433–44. doi: 10.1093/cid/civ297

Copyright (c) 2026 Olufunmilola Makanjuola, Gloria Igbor, Florence Bamigbola

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors retain copyright of their work, with first publication rights granted to IJIC. Read the full Copyright- and Licensing Statement.