CJIC Abstracts & Online Journal
This section features abstracts of scientific articles that have been published in the Canadian Journal of Infection Control prior to 2005, as well as online journals from 2005 to the present. Click here to find out more about the Journal.
The following full journal issues may be downloaded:
- Volume 35, Number 1 (Spring 2020) DOWNLOAD [8.5 MB]
- Practice Recommendations for Infection Prevention and Control Related to Foot Care in Healthcare Settings. Barry, C et al.
- Influenza and norovirus outbreaks in an inpatient mental health setting: Analysis and strategies for successful containment. Linkenheld-Struk, A et al.
- A novel imaging system for rapid visualization of bacteria on surfaces. Greene C and Hatt S
- An evaluation of conventional cleaning and disinfection and electrostatic disinfectant spraying in K-12 schools. Ford D and Sopha, K.
- COVID-19: Are you prepared for the next emerging disease? Salt, N.
- Volume 34, Number 4 (Winter 2019) DOWNLOAD [9.8 MB]
- Editorial: Why infection prevention and control professionals should strive to publish. Metcalf, D and Williams, V.
- Position Statement: VRE screening and contact precautions. Ashcroft, M
- Investigation of an outbreak of group A Streptococcus in a Regina retirement residence and personal care home, 2018. Danielson et. al.
- The effect of timing of oseltamivir chemoprophylaxis in controlling influenza B outbreaks in long-term care facilities in Manitoba, Canada, 2017-2018: A retrospective cohort study Singh et al.
- Trends in health care-associated infections in acute care hospitals in Canada: an analysis of repeated point prevalence surveys. Mitchell et al.
- Volume 34, Number 3 (Fall 2019) DOWNLOAD [9.3 MB]
- Position Paper: Surveillance in Long-Term Care Settings. Happe et al.
- Investigation of Clostridioides (Clostridium) difficile in a community hospital in Southern Ontario, Canada. Metcalf et al.
- Assessment of the infection prevention and control learning needs of Ottawa community-based healthcare providers. Cadieux et al. & Supplemental Material
- Gym Routine Infection Prevention program – An Innovative, Collaborative Approach towards Excellence. Naik et al. & Supplemental Material
- A case for integrating substance use harm reduction into IPAC practice in acute care settings. Wituik, C
- Volume 34, Number 2 (Summer 2019) DOWNLOAD [7.5 MB]
- Household hygiene advice for patients with Clostridium difficile: Summary of hospital practice in Ontario, Canada. Egan et al.
- Using scent detection dogs to identify environmental reservoirs of Clostridium difficile: Lessons from the field. Li et al.
- Value of Certification in Infection Prevention and Control (CIC®). Marx et al.
- Phenotypic and genotypic characteristics of communityacquired and hospital-acquired carbapenem-resistant Enterobacteriaceae in patients with liver cirrhosis at the National Liver Institute of Egypt. Awad et al.
- Position Paper: Reprocessing of Critical Foot Care Devices
- Volume 34, Number 1 (Spring 2019) DOWNLOAD [7.5 MB]
- Message from IPAC Canada
- Position Paper: Hepatitis B practice recommendations
- Incidence of surgical site infections after caesarean sections in a community hospital. Rouse et al.
- Healthcare workers’ attitudes toward hand hygiene practices:Results of a multicentre qualitative study in Quebec. Atif et al.
- Urine collection practices in a small rural hospital: Evaluation of alignment with antimicrobial stewardship guidelines. Irwin et al.
- Effective prevention bundle to eliminate catheter-related bloodstream infections in ambulatory hemodialysis patients. Hamid et al.
- Volume 33, Number 4 (Winter 2018) DOWNLOAD [7.2 MB]
- IPAC Canada Position Paper: Electronic devices practice recommendations
- Prevalence and risk factors of healthcare-associated infections in a Moroccan teaching hospital. Mahfoud Chiguer et al.
- Improvement of hospital environmental cleaning and disinfection practices following an eight-month outbreak. Meredith C. Faires et al.
- Facultative anaerobic bacteria on dentistry students’ gutta-percha points: The importance of disinfection. María del Pilar Angarita et al.
- Understanding infection control professionals’ educational practice: There is more to it than meets the eye. Gwyneth L. Meyer et al.
- Orthopaedic surgical site infections: A prospective cohort study. Anil K. Bhat et al.
- Susceptibility of catheter-related Klebsiella pneumoniae strains to quaternary ammonium compounds under biofilm and planktonic conditions Fatemeh Monirzadeh et al.
- Risk analysis of respiratory infections in facilities for patients with severe motor and intellectual disabilities in Japan. Naoki Takayama et al.
- Volume 33, Number 3 (Fall 2018) DOWNLOAD [7.2 MB]
- Position Statement-Medical Gels
- Environmental sampling of hospital surfaces: Assessing methodological quality. Jocelyn Chai et al.
- A spatial, temporal, and molecular epidemiological study of hospitalized patients infected with community acquired or healthcare-associated Clostridium difficile in the Niagara Region, Ontario, Canada between September 2011 and December 2013. Maryam Salaripour et al.
- Volume 33, Number 2 (Summer 2018) DOWNLOAD [4.7 MB]
- A cohort study of factors associated with LTBI treatment initiation and completion in Hamilton, Ontario, Canada. Deborah A. Milinkovic et al.
- An exploration of IPAC educational intervention research: What do we mean by education? Gwyneth L. Meyers et al.
- Volume 33, Number 1 (Spring 2018) DOWNLOAD [10.0 MB]
- UV-C light and infection rate in a long term care ventilator unit. Douglas W. Kane et al.
- Multi-drug resistant ventilator associated pneumonia: risk factors and outcomes
Hadiseh Hosamirudsari et al.
- Incidence and risk factors of surgical site infection in general surgery department of a Tunisian tertiary teaching hospital: A prospective observational study. Héla Ghali et al.
- Hip arthroplasty: Incidence and risk factors for surgical site infection. Lúcia Maciel de Castro Franco et al.
- Changing ICU culture to reduce catheter-associated urinary tract infections. Marcia Maxwell et al.
- Tuberculosis exposure in an oncology clinic and hospital environment: Not all exposures are equal. Emily A. Robbins et al.
- Practice and compliance of essential handwashing among healthcare workers at a regional referral hospital in Uganda: A quality improvement and evidence-based practice. Vallence Niyonzima et al.
- Volume 32, Number 4 (Winter 2017) DOWNLOAD [5.2 MB]
- A double-blinded randomized controlled trial of incise-drapes in spine surgery: A feasibility study. Vu Le et al.
- Antimicrobial stewardship with once-weekly follow-up reduced carbapenem prescriptions in an acute care hospital. Satoru Mitsuboshi et al.
- Microbial contamination on cell phones used by undergraduate students. N.E. Martínez-Gonzáles et al.
- Expanding central line care bundle to address line manipulations. Heena Sheth et al.
- How much do beds and mattresses sleep around? Automated measurement of bed frame and mattress movement in an acute care hospital. Colin D. Furness et al.
- Can the use of assistive technology and interactive therapeutic robots in nursing homes contribute to the spread of infectious disease? Jörn Klein et al.
- Volume 32, Number 3 (FALL 2017) DOWNLOAD [4.6 MB]
- Serratia marcescens outbreak causing septicemia in neonatal intensive care unit:Substantiation of single source. Abeera Ahmed et al.
- Engaging patients as observers in monitoring hand hygiene compliance in ambulatory care. Chaitali Desai et al.
- A new method to sterilize multichannel flexible colonoscopes. Sylvie Dufresne et al.
- Investigation of salmonellosis outbreak following a hospital endoscopy: A public health case study. Elaine Reddick.
- Taking your work home with you: Potential risks of contaminated clothing and hair in the dental clinic and attitudes about infection control. Taylor Davidson et al.
- Recommendations for conjunctivitis prevention in ophthalmology/optometry clinical office practice. Kevin Katz et al.
- Pseudomonas bacteremia; in vitro susceptibility pattern in a tertiary care hospital. Sonal Gupta et al.
- PVL toxin-producing methicillin-resistant Staphylococcus aureus (MRSA) are predominant
in a tertiary-care metropolitan teaching hospital. Lindsay P Kleinwak & Briana Leung et al.
- Volume 32, Number 3 (Supplement -Association News) DOWNLOAD [2.0 MB]
- Volume 32, Number 2 (SUMMER 2017) DOWNLOAD [6.4 MB]
- Risk factors and outcome analysis of gram-positive and gram-negative neonatal sepsis: A case-control study. Aradhana Bhargava et al.
- Clustering of Serratia marcescens infections during six years: Epidemiology and risk factors for mortality. Aysegul Ulu-Kilic et al.
- Clostridium difficile infection in Alberta’s long-term care facilities. Cliff Lindeman et al.
- Exploring the patient experience with recurrent Clostridium difficile infection in Ontario, Canada Kelsey Downie et al.
- Surface and air: What impact does UV-C at the room level have on airborne and surface bacteria? Linda D. Lee et. al.
- Lipid emulsion increases the risk of central line infection in Japanese adult inpatients: A retrospective study. Satoru Mitsuboshi et al.
- Comparison of bacterial loads of two types of hospital pillows: Perspectives of improving hospital hygiene standards. Silver Türk et al.
- Evaluation of efficacy and clinical utility of potassium peroxymonosulfate-based disinfectants. Tomoko Matsuoka et al.
- Volume 32, Number 1 (SPRING 2017) DOWNLOAD [6.4 MB]
- Comparison of the efficacy of two airborne disinfection products in reducing the Aspergillus fumigatus contamination from hospital false ceiling reservoirs. Loeffert ST et al.
- Expansion of a province-wide surveillance protocol to include community onset
healthcare-associated Clostridium difficile infection. Lesley A. McLeod.
- Saline flush after administration of lipid emulsion reduces the risk of central line infections: A case-control study. Satoru Mitsuboshi et al.
- The role of copper surfaces in reducing the incidence of healthcare-associated infections: A systematic review and meta-analysis. Ignacio Pineda et al.
- Device-associated infection rates in Intensive Care Units of five cities of the Kingdom of Saudi Arabia: International Nosocomial Infection Control Consortium (INCC) findings Hail M. Al-Abdely et al.
- Comparison of efficacy and cost of three different antimicrobial prophylaxis drugs
in microsurgical transsphenoidal surgery. Halil Ulutabanca et al.
- Volume 32, Number 1 (Supplement -Association News) DOWNLOAD [5.4 MB]
- Volume 31, Number 4 (WINTER 2016) DOWNLOAD [7 MB]
- Volume 31, Number 4 (Supplement -Program Wide Standard) DOWNLOAD [7 MB]
- Volume 31, Number 3 (Fall 2016) DOWNLOAD [7 MB]
- Volume 31, Number 2 (Summer 2016) DOWNLOAD [7 MB]
- Volume 31, Number 2 (supplement) DOWNLOAD [8.5MB]
- Volume 31, Number 1 (Spring 2016) DOWNLOAD [7 MB]
- Volume 30, Number 4 (Winter 2015) DOWNLOAD [6 MB]
- Volume 30, Number 3 (Fall 2015) DOWNLOAD [6 MB]
- Volume 30, Number 2 (Summer 2015) DOWNLOAD [6 MB]
- Volume 30, Number 1 (Spring 2015) DOWNLOAD [7 MB]
- Volume 29, Number 4 (Winter 2014) DOWNLOAD [7 MB]
- Volume 29, Number 3 (Fall 2014) DOWNLOAD [10 MB]
- Volume 29, Number 2 (Summer 2014) DOWNLOAD [10 MB]
- Volume 29, Number 1 (Spring 2014) DOWNLOAD [6.2 MB]
- Volume 28, Number 4 (Winter 2013) DOWNLOAD [4.4 MB]
- Volume 28, Number 3 (Fall 2013) DOWNLOAD [8.2 MB]
- Volume 28, Number 2 (Summer 2013) DOWNLOAD [5.9 MB]
- Volume 28, Number 1 (Spring 2013) DOWNLOAD [8.7 MB]
- Volume 27, Number 4 (Winter 2012) DOWNLOAD [4.5 MB]
- Volume 27, Number 3 (Fall 2012) DOWNLOAD [5 MB]
- Volume 27, Number 2 (Summer 2012) DOWNLOAD [6 MB]
- Volume 27, Number 1 (Spring 2012) DOWNLOAD [9 MB]
- Volume 26, Number 4 (Winter 2011) DOWNLOAD [7 MB]
- Volume 26, Number 3 (Fall 2011) DOWNLOAD [7 MB]
- Volume 26, Number 2 (Summer 2011) DOWNLOAD [6 MB]
- Volume 26, Number 1 (Spring 2011) DOWNLOAD [6.1 MB]
- Volume 25, Number 4 (Winter 2010) DOWNLOAD [5.7 MB]
- Volume 25, Number 3 (Fall 2010) DOWNLOAD [5.9 MB]
- Volume 25, Number 2 (Summer 2010) DOWNLOAD [5.7 MB]
- Volume 25, Number 1 (Spring 2010) DOWNLOAD [7 MB]
- Volume 24, Number 4 (Winter 2009) DOWNLOAD [2 MB]
- Volume 24, Number 3 (Fall 2009) DOWNLOAD [6 MB]
- Volume 24, Number 2 (Summer 2009) DOWNLOAD [6 MB]
- Volume 24, Number 1 (Spring 2009) DOWNLOAD [7 MB]
- Volume 23, Number 4 (Winter 2008) DOWNLOAD [6 MB]
- Volume 23, Number 3 (Fall 2008) DOWNLOAD [6 MB] [corrected]
- Volume 23, Number 2 (Summer 2008) DOWNLOAD [4.3 MB]
- Volume 23, Number 1 (Spring 2008)
- Volume 22, Number 4 (Winter 2007) DOWNLOAD [3.7 MB]
- Volume 22, Number 3 (Fall 2007) DOWNLOAD [3.8 MB]
- Volume 22, Number 2 (Summer 2007) DOWNLOAD [4.0 MB]
- Volume 22, Number 1 (Spring 2007) DOWNLOAD [4.6 MB]
- Volume 21, Number 4 (Winter 2006) DOWNLOAD [3 MB]
- Volume 21, Number 3 (Fall 2006) DOWNLOAD [2.7 MB]
- Volume 21, Number 2 (Summer 2006) DOWNLOAD [3.2 MB]
- Volume 21, Number 1 (Spring 2006) DOWNLOAD [3.3 MB]
- Volume 20, Number 4 (Winter 2005) DOWNLOAD [3 MB]
- Volume 20, Number 3 (Fall 2005) DOWNLOAD [2.6 MB]
- Volume 20, Number 2 (Summer 2005) DOWNLOAD [2.7 MB]
- Volume 20, Number 1 (Spring 2005) DOWNLOAD [3.4 MB]
The following are abstracts from journals prior to 2005:
- Volume 19, Number 4 (Winter 2004) [abstracts not available]
"Improving quality of service in a sterile processing and operating room setting"
"Surgical site infections: An obvious target for quality improvement and patient safety initiatives"
"CHICA-Canada® Position Statement: Perioperative Antibiotic Prophylaxis for the Prevention of Surgical Site Infection"
- Volume 19, Number 3 (Fall 2004) [abstracts not available]
"'Hospital Clean' versus 'construction clean' - is there a difference?"
"Safety engineered medical devices: An Ontario perspective"
"Enhancing you image: Infection Control and Human Resources working together"
"Aging infrastructure linked to C.difficile outbreak"
"Pandemic Flu Plan Draft"
"What makes a great Chapter better? SOPIC's Mentorship Program"
- Volume 19, Number 2 (Summer 2004) [abstracts not available]
"Lyme disease in North America: A review"
"International Federation of Infection Control (IFIC)"
- Volume 19, Number 1 (Spring 2004)
"West Nile virus in Canada, 2000-2003: The impact of an emerging infectious disease"
- Volume 18, Number 4 (Winter 2003 [abstracts not available]
"The state of infection surveillance and control in Canadian acute care hospitals"
"The Community Clergy and SARS: An educational opportunity"
"Infection Control and the OR Flash sterilization (steam)"
"Results of the 2003 CHICA-Canada® Membership Survey"
- Volume 18, Number 3 (Fall 2003) [abstracts not available]
"Incidence of nosocomial infections in a Canadian adult intensive care unit"
"Hospital planning for bioterrorism: are you prepared?"
- Volume 18, Number 2 (Summer 2003)
No abstracts in this volume. Special reports on SARS.
- Volume 18, Number 1 (Spring 2003) [abstracts not available]
"Alcohol hand sanitizers: an examination of the evidence of their efficacy"
"Teaching infection control through WebCT, across Canada and beyond"
"Construction issues and the ICP"
- Volume 17, Number 4 (Winter 2002)
"Practice analysis for infection control and epidemiology in the new millenium"
- Volume 17, Number 3 (Fall 2002) [abstract not available]
"A bird's eye view of infection control in Japan"
- Volume 17, Number 2 (Summer 2002)
"Lessons from the past: Tuberculosis nursing in British Columbia 1895-1945"
- Volume 17, Number 1(Spring 2002)
"Gastroenteritis in residential care facilities in British Columbia."
- Volume 16, Number 4 (Winter 2001)
"Methicillin-resistant Staphylococcus aureus and topical decolonization. How effective is it?"
- Volume 16, Number 3 (Fall 2001)
"The emerging epidemiology of vancomycin-resistant enterococci in Canada"
- Volume 16, Number 2 (Summer 2001)
"Development of a resource model for infection prevention and control programs in acute, long term, and home care settings: Conference Proceedings of the infection Prevention and Control Alliance"
- Volume 16, Number 1 (Spring 2001)
"Nosocomial Aspergillus wound infection in an intensive care unit patient resulting from environmental contamination"
Volume 19, Number 1 (Spring 2004)
West Nile virus is an emerging infectious disease in Canada, first detected in birds and moxquitoes in southern Ontario in 2001. This review article summarizes current information regarding the natural history and epidemiology of West Nile virus both worldwide and in Canada. Surveillance methods and preventive measures are discussed, with an emphasis on what is currently implemented in Canada.
Two years after the first reported human cases of West Nile Virus infection in humans, there is no clear indication of the magnitude of effect on public health in Canada. However, there are practical measures that individuals can use to minimize the risk of infection, especially those at high risk of infection or those more likely to experience more severe health outcomes. This information should be available from family physicians and public health units.
For complete article click here
Volume 17, Number 4 (Winter 2002)
Background: The Certification Board of Infection Control and Epidemiology appointed an advisory committee to conduct a practice analysis (PA) of infection control professionals (ICPs) to identify current practices of ICPs. Results of the PA would assist in the development of a revised certification examination.
Methods: Five thousand seven hundred fifty-three questionnaires were distributed to ICPs in the United States and in Canada, as well as to a subsample of ICPs in other countries. Decision rules and criteria were applied to each identified task in the PA.
Results: A total of 1306 responses were available for analysis, for a 24% return rate. The majority of the respondents were certified in infection control, had a background as a registered nurse, and worked in a community hospital with 200 or fewer beds. Six major categories, with 135 tasks, were identified in the PA. The following two new categories were included: education and research and infection control aspects of employee health.
Conclusions: The PA reflects current changes in the practice of infection prevention/control and applied epidemiology in the United States and Canada. The test specifications accepted for adoption by the Certification Board of Infection Control and Epidemiology will be used to build all examination forms for a certification program for ICPs.
In 1895, tuberculosis (TB) was epidemic world-wide, and the leading cause of death in British Columbia and Canada; in 1945, streptomycin was introduced as the "magic bullet" that, for several decades, conquered the disease. Although there was no effective cure, mortality rates in B.C. dropped from approximately 200 per 100,000 population to 55 per 1000,000 population during those 50 years. This remarkable drop occurred mainly because of infection control education carried out by health professionals with patients and families both within hospitals and in the community. Initially, most teaching was done by nurses hired by lay associations and volunteer agencies, and later through the newly established public health departments through public education campaigns. Unfortunately many nurses in hospitals, especially student nurses, became victims of the disease, mainly because they received poor education about infection control and because of poor practice in hospitals. This historical research article, drawing on primary and secondary documents, provides an overview of nursing's involvement that helped bring about the decline of TB in both the general population and, finally, among nurses themselves. Although this research focuses on a period more than 50 years ago, with the resurgence of TB world-wide today, there may be lessons to be learned from the past.
Volume 17, Number 1 (Spring 2002)
Every year in British Columbia, many Residential Care Facilities (RCF) experience outbreaks of gastroenteritis affecting both residents and staff. These outbreaks have a significant affect on the residents' quality of life and the staff's ability to provide care. Based on clinical signs and symptoms, most of the outbreaks are viral in origin. British Columbia Centre for Disease Control (BCCDC) coordinated 45 outbreaks (defined as three or more cases of gastroenteritis within a four day period) between January 1 and April 30, 2001. The majority of the outbreaks occurred in RCF. In response to this 88% increase over the previous year and requests from the field for an infection control procedure for controlling these outbreaks, BCCDC developed a guideline titled Managing Outbreaks of Gastroenteritis in Residential Care Facilities. This guideline was adapted from existing protocols developed by the Vancouver and Simon Fraser Health Regions.
The purpose of this Infection Control survey was to evaluate the recommendations from the BCCDC guideline. Characteristics of facilities that experienced outbreaks during this period and measures used to control outbreaks were evaluated and linkages with Antibiotic Resistant Organisms explored. Information was gathered through a mailed out/telephoned survey from 57 RCF in the province. Facilities that experienced gastroenteritis outbreaks were matched with similar control facilities that did not. Thirty-five (65%) of the surveys were completed. no significant differences were seen in outbreak vs. non-outbreak facilities although some interesting trends were observed. Results provide some insight into characteristics of residential care facilities that may lead to outbreaks of gastroenteritis and effectiveness of the infection control measures used to control those outbreaks.
Volume 16, Number 4 (Winter 2001)
Objective: To examine the success rate of mupirocin/chlorhexidine therapy (M/CT) in a group of hospitalised patients colonized with methicillin-resistant Staphylococcus aureus (MRSA).
Design: A retrospective analysis based upon a chart review of 146 patients identified as MRSA positive decolonized and tested post treatment between January 1992 and October 1996.
Setting: A 500-bed adult tertiary care hospital in London, Ontario, Canada.
Results: Two of 32 patients (6.25%) treated only with vancomycin were culture negative on follow-up screening. This compares to a 35.4% success rate (42/114) for those who received M/CT with or without vancomycin (p=0.003). Medical patients achieved a higher eradication rate than those persons on a surgical service, 51.1% vs. 24.3% (p=0.01). Those successfully decolonized had a survival rate of 95.1% compared to 73.3% for those not successfully decolonized (p=0.002). Very few of the total population (<4%) were MRSA positive only at an extra-respiratory site prior to or following decolonization.
Conclusions: The success rate for decolonization of hospitalised MRSA positive persons is poor, and therefore, this strategy should be limited to certain, well-defined subgroups within this population of patients.
Volume 16, Number 3 (Fall 2001)
Objective: To provide a rapid and efficient means to collect descriptive epidemiologic data on occurrences of vancomycin-resistant enterococci (VRE) in Canada.
Design and Methods: Passive reporting of data on individual or cluster occurrences of VRE using a one page surveillance form.
Setting: Periodic distribution to all Canadian Hospital Epidemiology members (CHEC), Infection Prevention and Control Canada (IPAC) members, l'Association des Professionnels pour la Prevention des Infections (APPI) members and provincial laboratories, representing 650 health care facilities across Canada.
Patients: Patients colonized or infected with vancomycin-resistant enterococci within Canadian Health care facilities.
Results: Until the end of 1998, 263 reports of VRE were received from 113 health care facilities in 10 provinces representing a total of 1,315 cases of VRE with 1,246 colonized (94.7%), 61 infected (4.6%) and 8 (0.6%) of unknown status. VRE occurrences were reported in 56% of acute care teaching facilities and in 38% of acute care community facilities. All facilities >800 beds reported VRE compared to only 10% of facilities with <200 beds (r=0.86). Medical and surgical wards accounted for 51.4% of the reported VRE. Sixty-five (24.7%) reportws indicated an index case was from a foreign country, with 85.2% from the United States and 14.8% from other countries. Some type of screening was conducted in 50% of the sites.
Conclusions: A VRE passive reporting network provided a rapid and efficient means to provide data on the evolving epidemiology of VRE in Canada.
Volume 16, Number 2 (Summer 2001)
There is mounting concern about the impact of health care restructuring on the provision of infection prevention services across the health care continuum. In response to this, Health Canada hosted two meetings of Canadian infection control experts to develop a model upon which the resources required to support an effectivek, integrated infection prevention and control program across the health care continuum could be based. The final models project the IPCP needs as tghree full time equivalent infection control professionals/500 beds in acute care hospitals and one full time equivalent infection control professional/150-250 beds in long term care facilities. Non human resource requirements are also described for acute, long term, community and home care settings.
Volume 16, Number 1 (Spring 2001)
A medical surgical intensive care unit liver transplant patient in a tertiary care teaching hospital developed a nosocomial Aspergillus wound infection. The appearance of the infection suggested airborne contamination with the fungi. An investigation was conducted to determine the probable environmental source of Aspergillus fumigatus that resulted in the infection. Environmental surface sampling led to the isolation of Penicillium species, Dematiaceous mould and other saprophytic moulds from the overhead bed monitor, Aspergillus species, Aspergillus niger, Penicillium species, and Dematiaceous mould from a ceiling exhaust grill, Penicillium species and saprophytic mould from a curtain rod and sprinkler, and Aspergillus species, Penicillium species, and Paecilomyces species from a ceiling drop space in the patient's room. It was believed that the patient's wound became contaminated via fungal spores that filtered through the perforated metal ceiling tiles and the exhaust grill of the ceiling plenum due to air pressure differentials in the room. To address the problem: Housekeeping was increased, and wet method dusting was practised, dust containment for all construction activities was increased, and changes in design of the ventilation system were recommended: constant air volume supply, and smooth non-perforated ceiling surfaces. To conclude, hospital design of space and ventilation systems can be key in helping to control nosocomial infections.