07-21-2017 12:27 PM
I did our 6 months environmental testing and the viable air sampling came back positive for Cladosporium at the entrance door of the Ante-Room, we had terminal cleaning done at least twice and we use Peridox (sporocidal) once a week. After having the company that do our tests come back for a retest, the results came back again positive with the same thing "Cladosporium" which is an actionable pathogen according to the lab that sent me the results.
Can someone guide me on how to fix this issue because I did a research but still not sure how can I fix this issue!!!
Thank you very much and appreciate your help.
Hossam Gamal, Pharm.D.
Director of Pharmacy Services
Lompoc Valley Medical Center
07-21-2017 01:49 PM
My name is Abby Roth. I recently joined the Clinical IQ team as the Director of Microbiology.
It is not uncommon to find Cladosporium or any mold in the ante room by the entrance door. This is where people will entering ungowned and may be brining mold spores in on their hair or clothing. If you don't have a passthrough this is also where materials will be entering. As part of your investigation look at how well personnel are following garbing, material transfer and cleaning SOPs. Be sure you are limiting the amount of materials that are being stored in the ante room and make sure there is no corrugated cardboard. Also check around the sink for any leaks. Good luck!
07-24-2017 11:53 AM
Thank you Abby for your reply.
We have a passthrough between the anteroom and buffer area and came back negative this time.
That entrance area that came back positive is next to the sink in the anteroom and where the demarcation line is as well. We don't take any cardboard into our anteroom and the staff is following the garbing procedure written by Eric Kastango and Kate Douglas.
I am going to check if there is any leaks around the sink per your recommendation but not sure if I need to do something in the HVAC system before we redo the air sampling again!
09-22-2017 10:26 AM
09-27-2017 11:02 AM
Viable sampling at that sink countertop was conducted and I will check my report to see if the floor is being tested (but I don't believe so).
We did triple clean the room, air handling and pressure was adjusted and we were able to see negative results when retested.
Thanks everyone for your input.
10-12-2017 12:30 PM
We are in the same boat, positive actionable microorganisms detected in the air in the Anteroom.
Did you perform a HEPA filter leak test?
We will probably do a terminal clean and have our engineering department check the sink for leaks and check the filter placement.
10-12-2017 12:51 PM
10-13-2017 07:51 AM
Cladosporium is a common indoor air mold and typically comes in on people and product. Make sure you are not doing any sampling on the dirty side of the line of demarcation and make sure you don't have any cardboard in the anteroom. Abby Roth and I did a webinar of EM investigations and remediation activities. It is posted on the Pharmacy OneSource website under webinar. It would be valuable for you to watch the webinar and read our the post-webinar Q&A. Thanks.
10-19-2017 11:26 AM
I did attend the webinar and it was very helpful, so I encourage anyone that have these issues to watch it as mentioned by Eric because it opened my eyes to other important things.
10-19-2017 01:13 PM
As an engineer, I question the aspect of not testing the "dirty side". The line of demarc (ante room) is not a physical barrier nor one that has the 40LPFM airflow requirement like an open walkthru between buffer and ante rooms. If there is anything on the floor, surfaces, or personnel that gets into the air of the "dirty" side of the ante room... it likely that the entire ante room will have it. My testing experience vouches for this in small compounding room setups. Now, if the negative pressure room is relatively close to this line of demarc, that air can get sucked into that negative pressure room as personnel complete the gowning and enter the clean side. Now there could be 2 rooms with issues. So, a sample of countertop or surface or maybe 2 (dirty side) is warranted in my view to show both "control" of the compounding room complex and as possible sources for results that maybe of concern in both the ante room and the negative pressure room.