Airborne outbreak of nosocomial Scedosporium prolificans infection

We describe six inpatients with acute non-lymphocytic leukaemia who developed invasive infection with Scedosporium prolificansresistant to amphotericin B, flucytosine, ketoconazole, fluconazole, and itraconazole. All six patients died. Phenotypic and genotypic assessment of samples from clinical mat...

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Bibliographic Details
Published in:The Lancet (British edition) 2001-04, Vol.357 (9264), p.1267-1268
Main Authors: Guerrero, Antonio, Torres, Pio, Duran, M Teresa, Ruiz-Díez, Beatriz, Rosales, Miguel, Rodriguez-Tudela, Juan Luis
Format: Article
Language:English
Subjects:
Adult
Antifungal agents
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bacteria
Biological and medical sciences
Cross Infection - mortality
Disease Outbreaks
Drug resistance
Drug Resistance, Microbial
Epidemics
Female
Hematologic and hematopoietic diseases
Humans
Infection Control
Infections
Leukemia
Leukemia, Myeloid, Acute - drug therapy
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Male
Medical sciences
Microbiology
Middle Aged
Mycetoma - mortality
Nosocomial infection
Outbreaks
Polymerase Chain Reaction
Preventive medicine
Scedosporium - drug effects
Scedosporium - isolation & purification
Scedosporium - pathogenicity
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Summary:We describe six inpatients with acute non-lymphocytic leukaemia who developed invasive infection with Scedosporium prolificansresistant to amphotericin B, flucytosine, ketoconazole, fluconazole, and itraconazole. All six patients died. Phenotypic and genotypic assessment of samples from clinical material and ambient air from the isolation rooms where the patients were being treated showed that the epidemic was caused by a single strain. After implementation of aerial control measures, there were no further infections with this organism. We conclude that fatal multidrug-resistant S prolificansepidemics can be aerially transmitted and can be prevented with implementation of appropriate infection-control measures.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(00)04423-8