Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

NIOSHTIC-2 Publications Search

Search Results

Outbreak of bloodstream infection with the mold Phialemonium among patients receiving dialysis at a hemodialysis unit.

Authors
Clark-T; Huhn-GD; Conover-C; Cali-S; Arduino-MJ; Hajjeh-R; Brandt-ME; Fridkin-SK
Source
Infect Control Hosp Epidemiol 2006 Nov; 27(11):1164-1170
NIOSHTIC No.
20039051
Abstract
BACKGROUND: Molds are a rare cause of disseminated infection among dialysis patients. OBJECTIVE: We evaluated a cluster of intravascular infections with the mold Phialemonium among patients receiving hemodialysis at the same facility in order to identify possible environmental sources and prevent further infection. DESIGN: Environmental assessment and case-control study. SETTING: A hemodialysis center affiliated with a tertiary care hospital. METHODS: We reviewed surveillance and clinical microbiology records and performed a blood culture survey for all patients. The following data for case patients were compared with those for control patients: underlying illness, dialysis characteristics, medications, and other possible exposure for 120 days prior to infection. Environmental assessment of water treatment, dialysis facilities, and heating, ventilation, and air-conditioning (HVAC) systems of the current and previous locations of the dialysis center was performed. Samples were cultured for fungus; Phialemonium isolates were confirmed by sequencing of DNA. Investigators observed dialysis access site disinfection technique. RESULTS: Four patients were confirmed as case patients, defined as a patient having intravascular infection with Phialemonium species; 3 presented with fungemia, and 1 presented with an intravascular graft infection. All case patients used a fistula or graft for dialysis access, as did 12 (75%) of 16 of control patients (P=.54). Case and control patients did not differ in other dialysis characteristics, medications received, physiologic findings, or demographic factors. Phialemonium species were not recovered from samples of water or dialysis machines, but were recovered from the condensation drip pans under the blowers of the HVAC system that supplied air to the dialysis center. Observational study of 21 patients detected suboptimal contact time with antiseptic agents used to prepare dialysis access sites. CONCLUSION: The report of this outbreak adds to previous published reports of Phialemonium infection occurring in immunocompromised patients who likely acquired infection in the healthcare setting. Recovery of this mold from blood culture should be considered indicative of infection until proven otherwise. Furthermore, an investigation into possible healthcare-related environmental reservoirs should be considered.
Keywords
Molds; Infectious-diseases; Infection-control; Environmental-exposure; Environmental-control; Microbiology; Fungi; Fungal-infections; Epidemiology; Microorganisms
Contact
Scott Fridkin, MD, MS C-09, Mycotic Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30333
CODEN
ICEPE3
Publication Date
20061101
Document Type
Journal Article
Email Address
skf0@cdc.gov
Funding Type
Grant
Fiscal Year
2007
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T42-OH-008672
Issue of Publication
11
ISSN
0899-823X
Source Name
Infection Control and Hospital Epidemiology
State
IL; GA
Performing Organization
University of Illinois-Chicago
TOP