Hostname: page-component-857557d7f7-gtc7z Total loading time: 0.001 Render date: 2025-12-03T03:23:13.806Z Has data issue: false hasContentIssue false
  • English
  • Français

A Cluster of Pseudofungemia Associated With Hospital Renovation Adjacent to the Microbiology Laboratory

Published online by Cambridge University Press:  21 June 2016

Victoria Hruszkewycz ,
Bruce Ruben ,
Catherine M. Hypes ,
Grace D. Bostic ,
Joanna Staszkiewicz  and
Jeffrey D. Band
Victoria Hruszkewycz
Affiliation:
Departments of Epidemiology, William Beaumont Hospital, Royal Oak, Michigan
Bruce Ruben
Affiliation:
Infectious Diseases, William Beaumont Hospital, Royal Oak, Michigan
Catherine M. Hypes
Affiliation:
Microbiology, William Beaumont Hospital, Royal Oak, Michigan
Grace D. Bostic
Affiliation:
Microbiology, William Beaumont Hospital, Royal Oak, Michigan
Joanna Staszkiewicz
Affiliation:
Departments of Epidemiology, William Beaumont Hospital, Royal Oak, Michigan
Jeffrey D. Band*
Affiliation:
Departments of Epidemiology, William Beaumont Hospital, Royal Oak, Michigan Infectious Diseases, William Beaumont Hospital, Royal Oak, Michigan
*
Department of Epidemiology, William Beaumont Hospital, 3601 W. 13 Mile Road, Royal Oak, MI 48073
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the clinical significance and source of fungemia following a cluster of positive blood cultures during a 3-day period.

Design:

Chart review was used to determine the clinical significance of positive blood cultures. Microbiologic sampling of the laboratory environment was used to determine potential sources of fungal contamination.

Setting:

A large, tertiary care, community teaching hospital.

Patients:

All patients with blood cultures positive for Aspergillus species, Penicillium species, or both during the outbreak period.

Results:

Thirteen patients, all children, were reported to have positive blood cultures for fungus during a 3-day period in early 1990. None had clinical features consistent with fungemia. Investigation of specimen processing procedures revealed that microbiologic plates were not processed-as per protocol-under the biologic hood but inadvertently were left open to air on the work bench by laboratory technicians. Settling plates left at the workbench, at door entry sites, and at sites of renovation immediately adjacent to the laboratory were positive for Aspergillus and/or Penicillium; control plates placed elsewhere were negative. Airflow patterns suggested spread into the microbiologic laboratory through an open door located near the implicated workbench station and a false ceiling above the workbench area.

Conclusions:

Our investigation demonstrates that faulty technique in the laboratory coupled with a change in environmental conditions can result in false-positive cultures and an outbreak of pseudofungemia.

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 13 , Issue 3 , March 1992 , pp. 147 - 150
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1. Gustafson, TL, Schaffner, W, Iaverly, GB, Stratton, CW, Johnson, HK, Hutcheson, RH. Invasive aspergillosis in renal transplant recipients: correlation with corticosteroid therapy. J Infect Dis.1983;148:230–238.Google Scholar
2. Rotstein, C, Cummings, KM, Tidings, J, et al. An outbreak of invasive aspergillosis among allogeneic bone marrow transplants: a case-control study. Infect Control. 1985;6:347–355.Google Scholar
3. Opal, SM, Asp, AA, Cannady, PB, Morse, PL, Burton, LJ, Hammer, PG. Efficacy of infection control measures during a nosocomial outbreak of disseminated aspergillosis associated with hospital construction. J Infect Dis. 1986;153:634–637.Google Scholar
4. Sherertz, RJ, Belani, A, Kramer, BS, et al. Impact of air filtration onnosocomial Aspergillus infections. Am J Med. 1987;83:709–717.Google Scholar
5. Klimowski, LL, Rotstein, C, Cummings, KM. Incidence of nosocomial aspergillosis in patients with leukemia over a 20-year period. Infect Control Hosp Epidemiol. 1989;10:299–305.Google Scholar
6. Barns, RA, Rogers, TR Control of an outbreak of nosocomial aspergillosis by laminar airflow isolation. J Hosp Infect. 1989;14:89–94.Google Scholar
7. Hopkins, CG, Weber, DJ, Rubin, RH. Invasive Aspergillus infection: possible non-ward common source within the hospital environment. J Hosp Infect. 1989;13:19–25.Google Scholar
8. Young, RC, Bennett, JE, Vogel, CL, Carbone, PP, DeVita, VT Aspergillosis: the spectrum of the disease in 98 patients. Medicine. 1970;49:147–173.Google Scholar
9. Krasinski, K, Holzman, RS, Hanna, B, Greco, MA, Graff, M, Bhogal, M. Nosocomial fungal infection during hospital renovation. Infect Control. 1985;6:278–282.Google Scholar
10. Arnow, PM, Andersen, RL, Mainous, PD, Smith, EJ. Pulmonary aspergillosis during hospital renovation. Am Rev Resp Dis. 1978;118:49–53.Google Scholar
11. Lentino, JR, Rosenkranz, MA, Michaels, JA, Kurap, VP, Rose, HD, Rytel, MW. Nosocomial aspergillosis. A retrospective review of airborne disease secondary to road construction and contaminated air conditioners. Am J Epidemiol. 1982;116:430–437.Google Scholar
12. Hoffman, PC, Arnow, PM, Goldmann, DA, Parrott, PL, Stamm, WE, McGowan, JE. False-positive blood cultures. Association with nonsterile blood collection tubes. JAMA.1976;236:2073–2075.Google Scholar
13. Weinstein, RA, Stamm, WE. Pseudoepidemics in hospital. Lancet. 1977:862–864.Google Scholar
14. Snydman, DR, Maloy, ME Brock, SM, Lyons, RW, Rubin, SJ. Pseudobacteremia: false-positive blood cultures from mist tent contamination. Am J Epidemiol. 1977;106:154–159.Google Scholar
15. Maki, DG. Through a glass darkly Nosocomial pseudoepidemics and pseudobacteremias. Arch Intern Med. 1980;140:26–28.Google Scholar
16. Kusek, JW. Nosocomial pseudoepidemics and pseudoinfections: an increasing problem. Am J Infect Control. 1981;9:70–74.Google Scholar
17. Graham, DR, Wu, E, Highsmith, AK, Ginsburg, ML An outbreak of pseudobacteremia caused by Enterobacter cloacae from a phlebotomist's vial of thrombin. Ann Intern Med. 1981;95:585–588.Google Scholar
18. Bille, J, Stockman, L, Roberts, GD, Horstmeier, CD, Ilstrup, DM. Evaluation of a lysis centrifugation system for recovery of yeasts and filamentous fungi from blood. J Clin Microbiol. 1983;18:469–471.Google Scholar