Review of fungal outbreaks and infection prevention in healthcare settings during construction and renovation

Hospital construction and renovation activities are an ever-constant phenomenon in healthcare facilities, causing dust contamination and possible dispersal of fungal spores. We reviewed fungal outbreaks that occurred during construction and renovation over the last 4 decades as well as current infection prevention strategies and control measures. Fungal outbreaks still occur in healthcare settings, especially among patients with hematological malignancies and those who are immunocompromised. The causative pathogens of these outbreaks were usually Aspergillus species, but Zygomycetes and other fungi were occasionally reported. Aspergillus most commonly caused pulmonary infection. The overall mortality of construction/renovation-associated fungal infection was approximately 50%. The minimal concentration of fungal spores by air sampling for acquisition of fungal infections remains to be determined. Performing infection control risk assessments and implementing the recommended control measures is essential to prevent healthcare-associated fungal outbreaks during construction and renovation.