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May 7, 2026Journal of Fungi1 citationsOpen Access

Airborne Fungal Monitoring in Healthcare Environments: A Systematic Review

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DSDana L SurwillPCPatricia CruzMBMark P. Buttner

Key Points

  • To evaluate current guidelines and practices for airborne fungal monitoring in healthcare settings.
  • Systematic review of peer-reviewed articles from four databases.
  • Focus on airborne fungal monitoring guidelines and practices.
  • Analysis of sample collection, culture media, incubation conditions, and results interpretation.
  • Eighteen articles met inclusion criteria.
  • Guidelines for acceptable airborne fungal levels ranged from <1 CFU/m3 in HEPA-filtered areas to >1000 CFU/m3 in non-filtered areas.
  • Common fungi identified included Aspergillus, Penicillium, Cladosporium, and Rhizopus.

Abstract

Background: Fungal infections pose a significant threat to public health, with over 6.55 million cases and 2.55 million deaths annually. Exposure to fungal spores in indoor environments primarily occurs through inhalation or direct contact with surfaces. Monitoring is critical for early detection and prevention of outbreaks, yet routine airborne fungal testing is not universally mandated across healthcare settings. Methods: A systematic review of peer-reviewed articles from four databases was conducted to identify current airborne fungal monitoring guidelines and best practices for sample collection, culture media, incubation conditions, and results interpretation. Results: Eighteen articles met the inclusion criteria, and four studies discussed potential guidelines for acceptable airborne fungal levels in healthcare environments. Guidelines ranged from 1000 CFU/m3 for non-filtered areas. The most common fungi identified were Aspergillus, Penicillium, Alternaria, Cladosporium, and Rhizopus, with six WHO-listed critical fungal pathogens found. Impaction was the sole sampling method used, with most studies employing Sabouraud dextrose or malt extract agar with chloramphenicol, incubation for 2–7 days at 25–30 °C, and morphological identification. Conclusions: The need for globally recognized fungal monitoring standards is pressing. Without them, preventable fungal exposure will persist, risking severe, potentially fatal infections for patients and healthcare workers.

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Cite This Study

Surwill et al. (2026) studied this question.

synapsesocial.com/papers/69fbe382164b5133a91a2b3chttps://doi.org/10.3390/jof12050336
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