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Epidemiology, Molecular Mycology, and Environmental Sources of Fusarium Infection in Patients with Cancer

Published online by Cambridge University Press:  02 January 2015

Issam Raad ,
Jeffrey Tarrand ,
Hend Hanna ,
Maher Albitar ,
Erle Janssen ,
Maha Boktour ,
Gerald Bodey ,
Masoud Mardani ,
Ray Hachem  and
Dimitrios Kontoyiannis
...Show all authors
Issam Raad*
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Jeffrey Tarrand
Affiliation:
Division of Laboratory Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Hend Hanna
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Maher Albitar
Affiliation:
Division of Laboratory Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Erle Janssen
Affiliation:
Department of Environmental Health and Safety, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Maha Boktour
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Gerald Bodey
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Masoud Mardani
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Ray Hachem
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Dimitrios Kontoyiannis
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Estella Whimbey
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
Kenneth Rolston
Affiliation:
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
*
Deartment of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 47, Houston, TX 77030
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Abstract

Objective:

To investigate the epidemiology and environmental sources of Fusarium infections in patients with cancer.

Design:

Retrospective case-control study conducted following surveillance environmental cultures and DNA analysis of isolated organisms.

Setting:

A tertiary-care, university cancer center.

Methods:

In 1996 and 1997, environmental cultures were performed on air samples and water systems. A retrospective chart review was performed for 70 patients with cancer identified with fusariosis between 1987 and 1997. Patients with fusariosis were compared with 49 uninfected control patients who occupied hospital rooms with positive environmental cultures for Fusarium. With the use of random amplification of polymorphic DNA organisms isolated from infected patients were compared with environmental organisms.

Results:

Most of the patients with Fusarium (40, 57%) were infected on or within 3 days of admission, indicating community rather than nosocomial acquisition. Patients were comparable in terms of underlying immunocompromised status to 49 uninfected control patients. However, the duration from admission to infection in the patients with fusariosis tended to be shorter than the duration from admission to discharge in the exposed control patients (P = .06). Water cultured from the hospital tanks and from sinks and water fountains was negative for Fusarium. With the use of polymerase chain reaction, environmental isolates did not match clinical ones. Quantitative air sampling showed that the quantitative outdoor Fusarium levels were eightfold higher than the indoor levels. During the rainy summer season, outdoor air concentrations of Fusarium were at their highest, coinciding with the peak incidence of fusariosis at our center.

Conclusion:

The most likely source of fusariosis was the external environment rather than nosocomial sources, such as water.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 9 , September 2002 , pp. 532 - 537
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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