An investigation of Aspergillus cardiac surgical site infections in 3 pediatric patients

• Published in: American journal of infection control 2007-06, Vol.35 (5), p.332-337
• Main Authors: Kronman, Matthew P., MD, Baden, Harris P., MD, Jeffries, Howard E., MD, MBA, Heath, Joan, RN, Cohen, Gordon A., MD, PhD, Zerr, Danielle M., MD, MPH
• Format: Article
• Language: English
• Subjects: Air Microbiology; Aspergillosis - etiology; Biological and medical sciences; Cardiac Surgical Procedures; Child, Preschool; Cross Infection - etiology; Cross Infection - microbiology; Epidemiology. Vaccinations; Equipment Contamination; Female; General aspects; Hospitals, Pediatric; Human infectious diseases. Experimental studies and models; Human mycoses; Humans; Infant; Infant, Newborn; Infection Control; Infectious Disease; Infectious diseases; Male; Medical sciences; Miscellaneous mycoses; Mycoses; Surgical Wound Infection - microbiology
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2006.10.013

Background Within a 3-month period, 3 pediatric patients at our hospital developed Aspergillus surgical site infections after undergoing cardiac surgery. Methods A multidisciplinary team conducted an epidemiologic review of the 3 patients and their infections, operative and postoperative patient care delivery, and routine maintenance of hospital equipment and air-filtration systems and investigated potential environmental exposures within the hospital that may have contributed to the development of these infections. Results Review of the patients and their infections, operative and postoperative patient care delivery, and routine maintenance did not reveal a source for infection. Inspection of operating room (OR) facilities identified several areas in need of repair. Of the 58 samples of air and equipment exhaust in the ORs and patient care areas, 11 revealed 2 to 4 colony-forming units of various Aspergillus species per cubic meter of air, and the remaining 47 samples were negative for Aspergillus . Eighty-three samples of surfaces and equipment water reservoirs were obtained from the OR and patient care areas. One culture of a soiled liquid nitrogen tank housed between the 2 cardiac ORs revealed 13 colony-forming units of Aspergillus. Conclusion No definitive source was identified, although a soiled liquid nitrogen tank contaminated with Aspergillus and kept near the OR was found and could have been a possible source.