Surveillance of patients identified with fungal mold at a public academic medical center

• Published in: American journal of infection control 2014-07, Vol.42 (7), p.776-780
• Main Authors: Patwari, Priti, MD, Cutrell, James, MD, Bhaskaran, Archana, MD, Trevino, Sylvia, MT, Sreeramoju, Pranavi, MD, MPH
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Adolescent; Adult; Aged; Biological and medical sciences; Child; Child, Preschool; Cohort Studies; Epidemiological Monitoring; Epidemiology; Epidemiology. Vaccinations; Female; Fungal infection; Fungal infections; Fungi - classification; Fungi - isolation & purification; General aspects; Health care–associated infection; Hospitals; Human infectious diseases. Experimental studies and models; Human mycoses; Humans; Infant; Infant, Newborn; Infection Control; Infectious Disease; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous mycoses; Mold; Mold infection; Mycoses; Mycoses - epidemiology; Mycoses - microbiology; Nosocomial infections; Prevalence; Retrospective Studies; Young Adult
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2014.03.025

Background This study describes the epidemiology of patients with fungal mold infection or colonization at a large academic medical center during a period of ongoing construction of a new hospital building. Methods This is an observational retrospective cohort study performed at a public academic hospital. We performed focused medical record review of all patients with fungal mold isolated on microbiologic culture over a 3-year period from May 2009 through April 2012. We established case definitions by modifying criteria used in previously published studies. We established 4 categories for invasiveness: proven invasive fungal disease (IFD), probable IFD, clinical infection not meeting IFD criteria, or colonization/contamination. We also established 3 categories for association with our health care facilities: health care–associated hospital onset (HO), health care–associated community onset (HACO), or community associated (CA). Results Of the 188 cases included in the study, 15 (7.9%) and 23 (12.2%) met criteria for proven and probable IFD, respectively. Of the cases, 114 (60.6%) represented contamination or colonization, and 36 (19.1%) had clinical infection not meeting IFD criteria. Epidemiologically, 46 (24.5%) cases were HO, 42 (22.3%) cases were HACO, and 100 (53.2%) cases were CA. Conclusion The surveillance methods we established were helpful for characterizing and monitoring fungal mold infections at the study institution.