Management of an Outbreak of Exophiala dermatitidis Bloodstream Infections at an Outpatient Oncology Clinic

Amber Vasquez; D Zavasky; N A Chow; L Gade; E Zlatanic; S Elkind; A P Litvintseva; P G Pappas; J R Perfect; S Revankar; S R Lockhart; T Chiller; J Ackelsberg; S Vallabhaneni

doi:10.1093/cid/cix948

Management of an Outbreak of Exophiala dermatitidis Bloodstream Infections at an Outpatient Oncology Clinic

Clin Infect Dis. 2018 Mar 5;66(6):959-962. doi: 10.1093/cid/cix948.

Authors

Amber Vasquez^{1

2}, D Zavasky³, N A Chow⁴, L Gade⁴, E Zlatanic³, S Elkind³, A P Litvintseva⁴, P G Pappas⁵, J R Perfect⁶, S Revankar⁷, S R Lockhart⁴, T Chiller⁴, J Ackelsberg⁸, S Vallabhaneni⁴

Affiliations

¹ Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.
² Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
³ Lenox Hill Hospital, Northwell Health System, New York, New York.
⁴ Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
⁵ University of Alabama at Birmingham.
⁶ Duke University Hospital, Durham, North Carolina.
⁷ Wayne State University, Detroit, Michigan.
⁸ New York City Department of Health and Mental Hygiene, New York.

PMID: 29121235
DOI: 10.1093/cid/cix948

Abstract

We report the presentation and management of 17 cases of Exophiala dermatitidis and Rhodotorula mucilaginosa bloodstream infections caused by a compounded parenteral medication at an oncology clinic. Twelve patients were asymptomatic. All central venous catheters were removed and antifungal therapy, primarily voriconazole, was administered to patients. Three patients died.

MeSH terms

Aged
Ambulatory Care Facilities
Antifungal Agents / therapeutic use
Asymptomatic Infections
Disease Management*
Disease Outbreaks*
Drug Contamination*
Exophiala / drug effects
Exophiala / isolation & purification
Female
Fungemia / drug therapy*
Fungemia / mortality
Humans
Immunocompromised Host
Male
Middle Aged
Oncology Service, Hospital
Outpatients
Phaeohyphomycosis / drug therapy*
Phaeohyphomycosis / mortality
Rhodotorula / drug effects
Rhodotorula / isolation & purification

Substances

Antifungal Agents