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A Cluster of Pseudofungemia Associated With Hospital RenovationAdjacent to the Microbiology Laboratory

Published online by Cambridge University Press:  21 June 2016

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

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 Aspergillusspecies, 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 forAspergillus 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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1992 

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