An outbreak of invasive fusariosis in a children's cancer hospital

Author(s):Show less -

Litvinov, Nadia ^{[1, 2]} ; da Silva, Mariama Tomaz N. ^{[3, 4, 5]} ; van der Heijden, Inneke M. ^{[3, 4, 5]} ; Graca, Mariana G. ^{[4, 5, 6]} ; de Oliveira, Larissa Marques ^{[4, 5, 6]} ; Fu, Liang ^{[4, 5, 6]} ; Giudice, Mauro ^{[3, 4, 5]} ; de Aquino, Maria Zilda ^[1] ; Odone-Filho, Vicente ^{[1, 2]} ; Marques, Heloisa Helena ^[2] ; Costa, Silvia F. ^{[4, 5, 6]} ; Levin, Anna S. ^{[3, 4, 5, 6]}

Affiliation

^[1] Hosp Clin Sao Paulo, Childrens Inst, Inst Tratamento Canc Infantil ITACI, Sao Paulo - Brazil

^[2] Hosp Clin Sao Paulo, Dept Pediat, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Inst Trop Med, BR-05508 Sao Paulo - Brazil

^[4] Hosp Clin Sao Paulo, Infect Control Dept, Sao Paulo - Brazil

^[5] Hosp Clin Sao Paulo, LIM 54, Sao Paulo - Brazil

^[6] Univ Sao Paulo, Dept Infect Dis, BR-05508 Sao Paulo - Brazil

• Document type: Journal article
• Source: Clinical Microbiology and Infection; v. 21, n. 3 MAR 2015.
• Web of Science Citations: 13

Abstract

Fusarium is considered an emerging pathogen, and there are few reports of fusariosis in children. The objective of this study was to describe an outbreak of invasive fusariosis in a children's cancer hospital. A neutropenic 17-year-old male patient hospitalized for 10 days for a relapse of acute myeloid leukaemia, under chemotherapy, presented fever without any other symptoms; a thoracic computerized tomography showed bilateral pulmonary nodules. During voriconazole treatment, 1-cm reddened and painful subcutaneous nodules appeared on arms and legs and the culture of a skin biopsy revealed F. solani. Another case occurred 11 days later and started an outbreak investigation. Water samples for cultures were collected from taps, showers and water reservoirs. Air from all patient rooms was sampled. Faucets and the drains of sinks and showers were swabbed and cultured. Environmental and clinical isolates were typed. There were 10 confirmed cases of infection caused by Fusarium spp. F. oxysporum and F. solani were isolated from water, swabs and air in patient rooms. Many control measures were instituted, but the outbreak was only controlled 1 year after the first case, when water filters filtering 0.2 mu m were installed at the exit of all faucets and showers in all patient rooms (points-of-use). Typing demonstrated that clinical isolates of F. oxysporum were similar to those of the environment. In conclusion, to our knowledge this is the first reported outbreak of invasive fusariosis in children with oncohaematologic disease. It was controlled using 0.2-mu m filters in all tap faucets and showers. Clinical Microbiology and Infection (C) 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. (AU)

• FAPESP's process: 12/02596-5 - Evaluation of 2 methods to detect Fusarium directly from water
• Grantee: Anna Sara Shafferman Levin
• Support Opportunities: Regular Research Grants