Setareh Davoudi1, Linda S Graviss2, Dimitrios P Kontoyiannis2. 1. Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2. Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Abstract
BACKGROUND: Healthcare-associated outbreaks of fungal infections, especially with uncommon and emerging fungi, have become more frequent in the past decade. MATERIALS AND METHOD: Here, we reviewed the history and definition of healthcare-associated outbreaks of uncommon fungal infections and discussed the principles of investigating, containing and treatment of these outbreaks. RESULTS: In case of these uncommon diseases, occurrence of two or more cases in a short period is considered as an outbreak. Contaminated medical devices and hospital environment are the major sources of these outbreaks. Care must be taken to differentiate a real infection from colonization or contamination. Defining and identifying cases, describing epidemiologic feature of cases, finding and controlling the source of the outbreak, treating patients, and managing asymptomatic exposed patients are main steps for outbreak elimination. These fungal outbreaks are not only difficult to detect but also hard to treat. Early initiation of appropriate antifungal therapy is strongly associated with improved outcomes in infected patients. Choice of antifungal drugs should be made based on spectrum, pharmacodynamic and pharmacokinetic characteristics and adverse effects of available drugs. Combination antifungal therapy and surgical intervention may be also helpful in selected cases. CONCLUSIONS: A multidisciplinary approach and close collaboration between all key partners are necessary for successful control of fungal outbreaks.
BACKGROUND: Healthcare-associated outbreaks of fungal infections, especially with uncommon and emerging fungi, have become more frequent in the past decade. MATERIALS AND METHOD: Here, we reviewed the history and definition of healthcare-associated outbreaks of uncommon fungal infections and discussed the principles of investigating, containing and treatment of these outbreaks. RESULTS: In case of these uncommon diseases, occurrence of two or more cases in a short period is considered as an outbreak. Contaminated medical devices and hospital environment are the major sources of these outbreaks. Care must be taken to differentiate a real infection from colonization or contamination. Defining and identifying cases, describing epidemiologic feature of cases, finding and controlling the source of the outbreak, treating patients, and managing asymptomatic exposed patients are main steps for outbreak elimination. These fungal outbreaks are not only difficult to detect but also hard to treat. Early initiation of appropriate antifungal therapy is strongly associated with improved outcomes in infectedpatients. Choice of antifungal drugs should be made based on spectrum, pharmacodynamic and pharmacokinetic characteristics and adverse effects of available drugs. Combination antifungal therapy and surgical intervention may be also helpful in selected cases. CONCLUSIONS: A multidisciplinary approach and close collaboration between all key partners are necessary for successful control of fungal outbreaks.
Authors: Luis Buzón Martín; Miguel Ángel Morán Rodríguez; Nicole Mercier; Maria Ortega Lafont; Eva Ojeda Fernández; Ana Ruiz de la Parte; Miguel Estefanía Journal: Mycopathologia Date: 2017-06-23 Impact factor: 2.574
Authors: Alexander J Sundermann; Cornelius J Clancy; A William Pasculle; Guojun Liu; Richard B Cumbie; Eileen Driscoll; Ashley Ayres; Lisa Donahue; Steven A Pergam; Lilian Abbo; David R Andes; Pranatharthi Chandrasekar; Alison L Galdys; Kimberly E Hanson; Kieren A Marr; Jeanmarie Mayer; Seema Mehta; Michele I Morris; John Perfect; Sanjay G Revankar; Becky Smith; Sankar Swaminathan; George R Thompson; Merin Varghese; Jose Vazquez; Estella Whimbey; John R Wingard; M Hong Nguyen Journal: Clin Infect Dis Date: 2019-02-15 Impact factor: 9.079