Program Schedule

950
An Outbreak of Invasive Fusariosis in a Children’s Cancer Hospital

Session: Poster Abstract Session: Outbreaks
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Fusarium is considered an emerging pathogen and there are few reports of fusariosis in children. The objective of this study was to describe an outbreak of invasive fusariosis in a children`s cancer hospital.

Methods: The outbreak occurred in a Children's Cancer Hospital with 15 beds. A neutropenic 17-year-old male hospitalized for 10 days for a relapse of acute myeloid leukemia, under chemotherapy, presented fever without any other symptoms; a thoracic computerized tomography showed bilateral pulmonary nodules. During voriconazole treatment, 1-cm, reddened and painful subcutaneous nodules appeared on arms and legs and the culture of a skin biopsy revealed F.solani. Another case occurred 11 days later and started an outbreak investigation. Water samples for cultures were collected from taps, showers and water reservoirs. Air from all patient rooms was sampled. Faucets and the drains of sinks and showers were swabbed and cultured.  Environmental and clinical isolates were typed.

Results:  There were 10 confirmed cases of infection caused by Fusarium spp. and 12 suspected cases.  F. oxysporum and F. solani were isolated from water, swabs and air in patient rooms. Many control measures were instituted but the outbreak was only controlled one year after the first case, when water filters filtering 0.2 µm were installed at the exit of all faucets and showers in all patient rooms (points-of-use). Typing demonstrated that clinical isolates of F. oxysporum were similar to those of the environment.

Conclusion: To our knowledge this is the first reported outbreak of invasive fusariosis in children with onco-hematologic disease. It was controlled using 0.2 µm filters in all tap faucets and showers.

Nadia Litvinov1, Mariama Tomaz Da Silva2, Larissa Oliveira3, Inneke Marie Van Der Heijden4, Liang Fung5, Maria Zilda Aquino6, Heloisa Helena De Sousa Marques7, Vicente Odone-Filho8, Heloisa Marques9, Silvia F Costa10 and Anna Levin11, (1)Hospital das Clinicas - University of São Paulo, Brazil, Sao Paulo, Brazil, (2)Hospital das Clinicas- University of Sao Paulo, Brazil, Sao Paulo, Brazil, (3)HOSPITAL DAS CLINICAS OF UNIVERSITY OF SAO PAULO, SAO PAULO, Brazil, (4)Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil, (5)Hospital das Clínicas- University of São Paulo, Brazil, Sao Paulo, Brazil, (6)Hospital das Clinicas - University of São Paulo, Brazil, São Paulo-SP, Brazil, (7)Hospital das Clínicas- University of São Paulo, São Paulo, Brazil, (8)University of São Paulo, Brazil, Sao Paulo, Brazil, (9)Infectious Diseases Department, Hospital das Clínicas- University of São Paulo, Brazil, Sao Paulo, Brazil, (10)Faculdade de Medicina USP, sao paulo, Brazil, (11)Department of Infectious Diseases, University of São Paulo, Brazil, São Paulo-SP, Brazil

Disclosures:

N. Litvinov, None

M. Tomaz Da Silva, None

L. Oliveira, None

I. M. Van Der Heijden, None

L. Fung, None

M. Z. Aquino, None

H. H. De Sousa Marques, None

V. Odone-Filho, None

H. Marques, None

S. F. Costa, None

A. Levin, None

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See more of: Poster Abstract Session

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