THE source of hospital mould which has been linked to the deaths of a number of heart surgery patients in Edinburgh remains a mystery, MSPs have been told.
In a statement to the Scottish Parliament, Health Secretary Jeane Freeman confirmed that six patients had contracted rare fungal infections at the Royal Infirmary of Edinburgh (RIE).
Some have since died - but an exact number has not been disclosed.
Read more: Warning letters about hospital bug symptoms sent to 186 heart surgery patients
Ms Freeman said the infections had been caused by three different types of mould not normally found in the hospital environment.
These are: Lichtheimia corymbifera; Exophiala dermatitidis; and Aspergillus.
Four operating theatres were closed as a precaution to enable special decontamination procedures to take place, including deep-cleaning with hydrogen peroxide vapour.
Two have since reopened, said Ms Freeman, and the remaining two would resume operations "as soon as possible".
All patients whose planned surgeries had been cancelled as a result have been rescheduled for surgery either this week or next, she added.
In a response to a question from Green MSP, Andy Wightman, Ms Freeman confirmed that that the source of the infection has not been identified.
"We continue to search for that," she said.
Read more: One in three patients in Scotland waiting longer than 18-week target for hip replacement
However, she added that the hospital's ventilation system had been fully checked and found to be "operating within normal parameters in terms of air pressure, air changes and flow".
It emerged on March 21 that NHS Lothian had written to 186 patients who had undergone aortic valve surgery at the RIE during the previous six months to notify them of a "very low" potential risk from mould infections, and the symptoms to look out for.
The action was taken after six patients who had undergone cardiothoracic surgery at the RIE between March 2017 and November 2018 went on to develop an "unusual and difficult to treat" infection in their heart valves, which in some cases proved fatal.
The health board stressed that there have been no further known cases since November 2018.
Addressing the Scottish Parliament, Ms Freeman said we "need to accept that not all healthcare-associated infections are preventable", but that she has instructed NHS Scotland's National Clinical Director, Professor Jason Leitch, to seek information and expertise internationally on whether any more can be done.
It follows a spate of high-profile hospital fungal infection deaths involving the Queen Elizabeth University Hospital in Glasgow.
Prosecutors are investigating the deaths of a 10-year boy and woman, 73, who contracted infections linked to pigeon droppings, as well as the death of a 63-year-old woman from a rare mould infection normally associated with soil or rotten fruit and vegetables.
Ms Freeman said: "We need to ask, were these types of infection always existent but masked by more common things like MRSA?
"Could it be that as these types of infection are going down, others are emerging? We don't know."
The Health Secretary added that Scotland has the lowest prevalence of healthcare-associated infections compared to the rest of the UK and the Republic of Ireland.
Scotland also "compared favourably" to European nations including Finland, Spain, France, Portugal and Greece, she added.
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