Fungi Assessment in Indoor and Outdoor Environment of Four Selected Hospitals in Peninsular Malaysia

Hospital buildings require special attention to protect patients and healthcare workers from hospital-acquired infections and sick building illnesses. This is the first study to assess the prevalence of fungus in indoor air, outdoor air, and their contamination on surfaces at selected locations in four highly contaminated hospitals (A, B, C, and D) in Peninsular Malaysia. A total of 294 indoor air samples, 106 scrapped and 169 swabbed, were collected from July 2019 to August 2020. Bioaerosol concentrations were calculated using the colony-forming unit (CFU)/m³. Molecular identification was performed on the cultures. The internal transcribed spacer (ITS) region in the rRNA gene of the isolates was amplified by PCR. Results showed that fungal burden was in the range between 18 and 2597 CFU/m³. Fungal load in selected locations at Hospital D were in the higher range between 106 and 2597 CFU/m³, with two locations exceeding the national guidelines. Fungal genera were highly identified in air samples (47) compared to swabbed (29) and scrapped (18) samples. The dominant species were <i>C. halotolerans</i>, <i>C. tenuissimum</i>, <i>P. alfredii</i>, <i>P. brevicompactum</i>, <i>P. brocae</i>, <i>P. cataractarum</i>, and <i>A. aculeatus</i>. Fungal loads were higher in the Orthopedic and Oral Surgeon Clinic, the On Call Emergency Room, wards, and pathways.