Airborne fungi in the hospital environment: profile of antifungal susceptibility and allergenicity

Airborne fungi are a health problem. This study investigated the diversity of airborne fungi in the surgical center and intensive care unit of a tertiary hospital in Caruaru, Pernambuco, Brazil, and evaluated their antifungal susceptibility profile and allergenicity. Critical and semicritical areas were sampled by passive sedimentation, and fungal strains were identified by morphological and molecular techniques. Thermophilic species were selected for in vitro susceptibility profiling against amphotericin B, isavuconazole, itraconazole, and voriconazole and for in vitro allergen detection. Aspergillus, Penicillium, and Cladosporium were predominant. Aspergillus, P. lilacinum, and R. pusillus responded to itaconazole, isavuconazole, and amphotericin B, respectively. Aspergillus neoafricanus does not respond to drugs. Aspergillus costaricensis, A. terreus and P. lilacinum have high allergenic potential. This was the first documented occurrence of P. costaricense in South America, its first report as anemophilous and its second worldwide record. This study contributes to the knowledge of the geographic distribution of airborne fungi in hospital environments, raises awareness of the importance of environmental hygiene in health, warns of the emergence of species with pathogenic or allergenic profiles present in these environments and highlights the positive aspects of conducting research of this type. However, it is understood that there is a need for continued education related to topics that directly impact the health of the population so that effective changes can be implemented and observed in the community as a whole, since One Health is in collective thinking and inherent to environmental, human and animal health, with a view to promoting the well-being and harmony of all.