1. Post transplant lung infection – Environmental pollution ? Association
NIMS + EPTRI
Hyderabad

7. Dr.Bharathi

8. ..
Infections are the main cause of morbidity and mortality of patients who are on immunosuppression medications.
From january 2016, we have series of patients on immunosuppression who got admitted with respiratory tract infections.

9. Age/sex
Pri.diag
infection
confirmation
outcome
Area ofresidence
Preandpost trans3m
Time of infection
30/m
renaltrans
PCP
HPE,LUNG
death
santoshnagar 6m
28/m
Recovered
masabtank
40/m
PCP,CMV
BAL cytology
recoverd
warngal
punjagutta
8yrs
36/f
HPE
kukatpally
2yrs
50/m
PNEMONIA
STERILE
LBnagar
PNEUMONIA 3m
30/f
11m
38/f
ECOLI
sputumcultu
recovered
karimnagar
10yrs
58/f
PTB
SPUTUM
dilshuknagar 2m
52/m
rhinocerebralmucor
Swabc/s
sytemicmucor
srnagar
1yr

11. Hypothesis: Environmental pollution is the source of infection.
To test this hypothesis ,we did air culture from 4 different areas to which patients are frequently exposed.
Both bacterial and fungal culture
A1-Transplant op
A2- sample collection room
A3-residential area
A4-KTU.

12. SAMPLAIR

14. Z

15. A1 – Transplant OP area

16. A2 – Blood Sample collection room

17. A3 – Residential area

18. A4 - KTU

19. Common organisms in environment

20. Dr.Uma

21. EPTRI -DATA

22. ..

23. ..

24. Dr.Kamala

25. Dr.Bharathi

26. DISCUSSION
 A new WHO air quality model- 92% of the world’s population lives in places where air quality levels exceed WHO limits*
3 million deaths a year are linked to exposure to outdoor air pollution.
Nearly 90% of air-pollution-related deaths occur in low- and middle-income countries, with nearly 2 out of 3 occurring in WHO’s South-East Asia and Western Pacific regions.

27. Aerobiology is the study of the processes involved in the movement of microorganisms in the atmosphere from one geographical location to another, including the aerosolized transmission of disease.
droplet and airborne

28. Droplet transmission - expelled particles that are likely to settle to a surface quickly.
airborne transmission -expelled particles that remain suspended in air for long periods of time.
World Health Organization uses a particle diameter of 5𝜇m to delineate between airborne (≤5𝜇m) and droplet (>5𝜇m) transmission.

29. ..

30. AIRBORNE INFECTION

31. Journal of pathogens,2002

32. prevention
Concerning personal controls, an essential personal protective practice is the regular and proper wearing of N95respirator masks.
Escombe et al. demonstrated that, provided that there is a sufficient circulation inside the room to mix the air, upper-room UV fixtures have been shown to be an effective intervention for use in infection control in high-risk clinicalsettings (e.g., tuberculosis)

33. Advances in Preventive Medicine Volume 2011, Article ID 124064

34. …
Kowalski and Bahnfleth showed that under certain conditions, using recirculated air with high-efficiency particulate air (HEPA) filters reduces particulate concentration for indoor air similar to full outside air system.
Healthcare facilities are subject to regulations and requirements relating to their HVAC systems . Based on these regulations, hospitals currently attempt to reduce the airborne infectious disease load by
increasing the air changes per hour (a measure of how many times the air within a defined space is replaced per hour) in areas known to be problematic
2) utilizing different ventilation configurations and systems in specific areas

35. Public awareness
WHO is rolling out BreatheLife, a global communications campaign to increase public awareness of air pollution as a major health and climate risk. 

36. ..
 "For people to be healthy, they must breathe clean air from their first breath to their last.”