Sedighe Karimpour Roshan - Department of Environmental Health, School of Health and Research Center for Health, Safety and Environment, Alborz University of Medical Sciences, Karaj, Iran.
Hatam Godini - Department of Environmental Health, School of Health and Research Center for Health, Safety and Environment, Alborz University of Medical Sciences, Karaj, Iran.
Saham Ansari - Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences. Tehran, Iran.
Arezoo Charsizadeh - Immunology, Asthma & Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Maryam Norouzi - Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences. Tehran, Iran.

Introduction: Fungal aerosols cause life-threatening infections in patients hospitalized in critical wards. Antiseptics and disinfectants have broad-spectrum antimicrobial activity against the living tissue and inert surfaces microorganisms; hence, they have an essential role in controlling and preventing nosocomial infections. This study aimed to evaluate in vitro antifungal activity of benzalkonium chloride (BAC), chlorhexidine digluconate (CHX), and sodium hypochlorite (SH) against isolated fungal aerosols from the hospital environment. Materials and Methods: The susceptibility tests were performed on fungal aerosols isolated from various wards of Children’s Medical Center, based on broth microdilution antifungal susceptibility testing of filamentous fungi approved by Clinical and Laboratory Standards Institute (CLSI) M۳۸-A۲ document. The isolates included Aspergillus (Aspergillus flavus (n = ۱۴), Aspergillus niger complex (n = ۱۲), Penicillium spp. (n = ۱۴), and Cladosporium spp. (n = ۱۴). Results: The geometric means (GM) of the Minimum Inhibitory Concentrations (MICs) of the biocides across all isolates were as follows: BAC, ۳.۵۶ µg/ml, CHX, ۹.۴۵ µg/ml, and SH, ۸۱۰.۳۵ µg/ml. The highest range of MICs was found for SH (۵۰-۱۲۸۰۰ µg/ml), while the lowest range was for BAC (۱-۱۶ µg/ml) against all fungal isolates. Generally, BAC showed the highest in vitro activity among disinfectants tested. The lowest MIC۵۰ and MIC۹۰ values were ۴ and ۸ µg/ml for BAC, followed by ۱۶ and ۳۲ µg/ml for CHX, and ۸۰۰ and ۶۴۰۰ µg/ml for SH, respectively. Conclusion: The findings showed that BAC was an effective disinfectant, which can prevent resistant species and fungal pathogens and be used as an alternative to other disinfectants and antiseptics.

Fungi, Aerosol, Disinfectants, Hospital, Antifungal Agents.