Interventions Implemented to Remediate Mold Identified in Neonatal Intensive Care Unit (NICU) Incubators, 2022-2023

Am J Infect Control. 2024 Oct 30:S0196-6553(24)00821-6. doi: 10.1016/j.ajic.2024.10.032. Online ahead of print.

Abstract

Introduction: Neonatal Intensive Care Units (NICUs) utilize incubators to sustain core temperatures associated with transepidermial water loss. High relative humidity in incubators provide an environment for fungi to grow. In August 2022, mold was identified growing in eleven (85%) NICU incubators.

Methods: A team assembled to address mold in incubators. The environment was addressed as a possible source of contamination by consulting an environmental specialist. The air handler, ducts, and environment were terminally cleaned. Specimens were collected from the contaminated incubators and the manufacturer reviewed cleaning practices. Experimental trials were conducted using the incubators to replicate mold growth after interventions.

Results: The environmental consultant approved when the space could be reoccupied. Incubators introduced to the clean environment did not grow mold. Various fungi and/or yeast were identified in the contaminated incubators. Opportunities to improve cleaning and replacement of parts were identified by the manufacturer. September 2022-February 2023, seven experimental trials were completed after cleaning the incubators. Four (36%) of the eleven contaminated incubators were placed back in use due to no fungal growth. No patient illnesses occurred.

Conclusion: The interventions implemented stopped ongoing contamination of incubators and use of previously contaminated incubators.

Keywords: NICU; fungi; mold; yeast.