BACKGROUND: Microorganisms considered saprophytes have emerged as invasive or indolent pathogens among immuno-compromised patients. MATERIAL AND METHODS: We detected an initial case of catheter-related Acremonium sp fungemia on a previously asymptomatic patient. We diagnosed a second case five weeks later. Both patients had a non-tunneled central venous catheter (CVC) that had been cared for following routine protocol by nurses in the Intravenous Therapy Team on a weekly basis. The sole risk factor that both patients shared was that they had received total parenteral nutrition (TPN) by a CVC 5 months prior to the date the catheter-related fungemia was detected. We retrospectively studied all patients who had received TPN during this period. RESULTS: We found two cases ofAcremonium fungemia, patients had gastric adenocarcinoma and received TPN for an average of 19 days. Infection was resolved with catheter removal and antifungic therapy. Another eight patients received TPN from the same commercial firm during this period; average administration was 9.5 days (range, 6-20). Neither blood cultures nor tip-catheters culture reported Acremonium sp. CONCLUSIONS: Patients with CVC for TPN should be closely monitored to identify colonization with a low pathogenic microorganism that could be mistakenly diagnosed as asymptomatic.
BACKGROUND: Microorganisms considered saprophytes have emerged as invasive or indolent pathogens among immuno-compromised patients. MATERIAL AND METHODS: We detected an initial case of catheter-related Acremonium spfungemia on a previously asymptomatic patient. We diagnosed a second case five weeks later. Both patients had a non-tunneled central venous catheter (CVC) that had been cared for following routine protocol by nurses in the Intravenous Therapy Team on a weekly basis. The sole risk factor that both patients shared was that they had received total parenteral nutrition (TPN) by a CVC 5 months prior to the date the catheter-related fungemia was detected. We retrospectively studied all patients who had received TPN during this period. RESULTS: We found two cases ofAcremonium fungemia, patients had gastric adenocarcinoma and received TPN for an average of 19 days. Infection was resolved with catheter removal and antifungic therapy. Another eight patients received TPN from the same commercial firm during this period; average administration was 9.5 days (range, 6-20). Neither blood cultures nor tip-catheters culture reported Acremonium sp. CONCLUSIONS:Patients with CVC for TPN should be closely monitored to identify colonization with a low pathogenic microorganism that could be mistakenly diagnosed as asymptomatic.