Alfred intensive care unit upgrade to fight fungus

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Alfred intensive care unit upgrade to fight fungus

The Age - Melbourne,,Australia

http://www.theage.com.au/news/national/alfred-intensive-care-unit-

upgrade-to-fight-fungus/2006/04/19/1145344155773.html

By Carol Nader

April 20, 2006

Page 1 of 2 | Single page

MELBOURNE'S busiest trauma hospital is rebuilding its intensive care

unit to eradicate a potentially dangerous fungus that has troubled

it for four years.

Just six years after it was opened, the State Government is spending

$20 million upgrading The Alfred's intensive care unit, which the

hospital expects to be completed in 2008.

The Government initially announced the upgrade in October last year

but failed to mention the aspergillus problem of 2002, instead

alluding to " a range of challenges " , citing emerging infectious

diseases.

The airborne aspergillus fungus is no threat to healthy people. But

it has the potential to harm people with vulnerable immune systems

after a bone marrow, heart or lung transplant.

In 2002, the hospital's intensive care unit had levels of

aspergillus two to three times higher than acceptable. The hospital

said levels were now " acceptable " , and no patient was at risk.

The Alfred responded at the time by creating a separate intensive

care unit with six beds for patients who had had transplants. Other

patients are not believed to be at risk.

The Alfred monitors levels of aspergillus each month and has changed

the airflow management to increase the pressure within the unit and

reduce the entry of outside air which may contain aspergillus.

But now the hospital wants to operate a single intensive care unit,

bringing patients in from the secondary unit. The hospital's chief

executive, , said a series of reviews had

recommended that the safest solution was to rebuild it.

" We very much want to get back to the situation we were in in 2002,

where we had one intensive care unit, " she said. " We don't want to

put at risk those particularly sick patients in case the levels were

to go up again, but they haven't gone up again. There have been no

aspergillus infections since 2002 and we want this to continue. "

Canberra Hospital director of infectious diseases, Collignon,

said aspergillus affected people when they breathed it in.

" It can often then form a lung infection and sometimes via the blood

go to other parts of the body, but that only occurs in people who

are very immuno-suppressed, " he said.

He said most major hospitals that cared for people with damaged

immune systems would have infections caused by aspergillus, but it

was difficult to know whether they picked it up in hospital or

elsewhere.

Ms said the unit would be built on the same site as the

existing one. Planning is under way and the hospital will relocate

patients when construction begins. She said it would be designed to

minimise the chances of aspergillus entering the unit.

" It's a matter of ensuring that the roof and the perimeter walls are

completely sealed and the air-conditioning system is replaced with

increased levels of air filtration capability, " she said.

The redesign will also boost the hospital's capacity to treat more

patients, with more beds and facilities to deal with infection

control, and new technology.

The Alfred acknowledged the elevated levels of aspergillus in 2002

when a patient with a compromised immune system died of aspergillus

pneumonia. But it cannot be determined whether the patient

contracted it in hospital or in the community. The fungus was also

found in 41 other patients, but they were not infected with it.

There have been no deaths or infections since.

Ben Hart, spokesman for Health Minister Bronwyn Pike, said The

Alfred had tried a number of measures to solve the aspergillus

problem, including building works to the air-conditioning and the

roof.

" But following that, it became apparent after a number of years that

those measures weren't solving the problem and so therefore expert

consultants were brought in to provide advice on what was the best

course of action and The Alfred formed a view that the best course

of action was a total rebuild, " he said.

WHAT IS ASPERGILLUS?

ASPERGILLUS is a common type of fungus that is better known to

people as mould. It is one of the funguses that causes bread to go

mouldy. It grows wherever there is organic material, such as compost

heaps and refrigerators, and can also be found in air-conditioning

systems and hospitals. It is harmful only in people whose immune

systems are severely damaged.