A polymicrobial fungal outbreak in a regional burn center after Hurricane Sandy

Geeta Sood; Dhananjay Vaidya; Lisa Dam; Lisa M Grubb; Jonathan Zenilman; Kelly Krout; Zeina Khouri-Stevens; Richard Bennett; Renee Blanding; Stefan Riedel; Stephen Milner; Leigh Ann Price; Trish M Perl

doi:10.1016/j.ajic.2018.01.011

A polymicrobial fungal outbreak in a regional burn center after Hurricane Sandy

Am J Infect Control. 2018 Sep;46(9):1047-1050. doi: 10.1016/j.ajic.2018.01.011. Epub 2018 Mar 30.

Authors

Affiliations

¹ The Johns Hopkins University, School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Baltimore, MD. Electronic address: [email protected].
² The Johns Hopkins University, School of Medicine, Department of Medicine, Division of General Internal Medicine, Baltimore, MD.
³ Johns Hopkins Bayview Medical Center, Baltimore, MD.
⁴ The Johns Hopkins University, School of Medicine, Department of Internal Medicine, Division of Infectious Diseases, Baltimore, MD.
⁵ The Johns Hopkins University, School of Medicine, Department of Pathology, Division of Microbiology, Baltimore, MD.
⁶ The Johns Hopkins University, School of Medicine, Department of Plastic Surgery, Baltimore, MD.

PMID: 29609856
DOI: 10.1016/j.ajic.2018.01.011

Abstract

Objective: To describe a polymicrobial fungal outbreak after Hurricane Sandy.

Design: An observational concurrent outbreak investigation and retrospective descriptive review.

Setting: A regional burn intensive care unit that serves the greater Baltimore area, admitting 350-450 burn patients annually.

Patients: Patients with burn injuries and significant dermatologic diseases such as toxic epidermal necrolysis who were admitted to the burn intensive care unit.

Methods: An outbreak investigation and a retrospective review of all patients with non-candida fungal isolates from 2009-2016 were performed.

Results: A polymicrobial fungal outbreak in burn patients was temporally associated with Hurricane Sandy and associated with air and water permeations in the hospital facility. The outbreak abated after changes to facility design.

Conclusions: Our results suggest a possible association between severe weather events like hurricanes and nosocomial fungal outbreaks. This report adds to the emerging literature on the effect of severe weather on healthcare-associated infections.

Keywords: Burn unit; Fungal infection; Fungal outbreak.

Publication types

Observational Study

MeSH terms

Baltimore / epidemiology
Burn Units*
Burns / complications*
Coinfection / epidemiology*
Coinfection / microbiology
Cyclonic Storms*
Dermatomycoses / epidemiology*
Dermatomycoses / microbiology
Disease Outbreaks*
Fungi / classification
Fungi / isolation & purification*
Humans
Intensive Care Units
Retrospective Studies
Risk Factors