Journal Article

Nosocomial Outbreak of <i>Exophiala jeanselmei</i> Fungemia Associated with Contamination of Hospital Water

Nucci Marcio, Akiti Tiyomi, Barreiros Gloria, Silveira Fernanda, Sanjay G. Revankar, L. Wickes Brian, Deanna A. Sutton and Thomas F. Patterson

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 11, pages 1475-1480
Published in print June 2002 | ISSN: 1058-4838
Published online June 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/340344
Nosocomial Outbreak of Exophiala jeanselmei Fungemia Associated with Contamination of Hospital Water

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From December 1996 through September 1997, we diagnosed 19 cases of fungemia due to Exophiala jeanselmei. We conducted a matched case-control study in which we cultured specimens of blood products, intravenous solutions, and water from a hospital water system. Isolates from environmental cultures were compared to those recovered from patients by random amplification of polymorphic DNA (RAPD). Multivariate analysis showed that neutropenia, longer duration of hospitalization, and use of corticosteroids were risk factors for infection. Environmental cultures yielded E. jeanselmei from 3 of 85 sources: deionized water from the hospital pharmacy, 1 water tank, and water from a sink in a non–patient care area. Use of deionized pharmacy water to prepare antiseptic solutions was discontinued, and no additional cases of infection occurred. RAPD typing showed that isolates from case patients and isolates from the pharmacy water were highly related, whereas the patterns of isolates recovered from the 2 other sources of water were distinct.

Journal Article.  3037 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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