416. Culture-documented invasive mold infections (cIMIs) at MD Anderson Cancer Center (MDACC) in Houston, TX pre and post hurricane Harvey
Session: Poster Abstract Session: Fungal Disease: Management and Outcomes
Thursday, October 4, 2018
Room: S Poster Hall
Background: Hurricane Harvey caused record flooding in late August 2017. As flood damage causes mold overgrowth, excess rates of IMIs in immunocompromised cancer patients (pts) is of concern.

Methods: We compared the rates (pt-1000 days) of cIMIs (EORTC/MSG criteria), in the period 7 months preceding and 7 months following hurricane Harvey, diagnosed in cancer pts at our institution. We focused on the 4 molds (Aspergillus, Fusarium, Mucorales, Scedosporium) that account for the vast majority of cIMIs in our patient population.

Results: No changes in cIMI rates (0.184 pre-Harvey vs 0.171 post–Harvey, P=NS) and mold distribution as causes of cIMIs were seen (table). No increased cases of cIMIs were encountered amongst different services (table), including pts with lymphoma/multiple myeloma or solid tumors (40% pre-Harvey vs 31% post-Harvey, P=NS).

Conclusion: Despite concerns for extensive environmental mold exposure after hurricane Harvey, we did not detect increased rates of cIMIs nor the emergence of unusual molds as causes of IMIs in high risk cancer pts at MDACC, including in pts with solid tumors, where mold-active prophylaxis is not used. Whether excess IMI cases not fitting the traditional diagnostic criteria (e.g., biomarker-positive but culture-negative IMIs) or pneumonias not requiring hospitalization were seen, requires further study.

Inpatient Hospital Infection Rates 7 Months Pre Harvey

Inpatient Hospital Infection Rates 7 Months Post Harvey

Aspergillus

0.1506

0.1621

Mucorales

0.0167

0.0000

Fusarium

0.0167

0.0085

Scedosporium

0.0000

0.0000

Total

0.1840

0.1706

Inpatient Service Line Infection Rates 7 Months Pre Harvey

Inpatient Service Line Infection Rates 7 Months Pre Harvey

MM/Lymphoma

0.3185

0.2441

Solid Tumor

0.0588

0.0594

Leukemia

0.3655

0.5052

Stem Cell Transplant

0.1835

0.184

Dimitrios P. Kontoyiannis, MD, ScD, PhD (Hon), FACP, FIDSA, FECMM, FAAM, Department of Infectious Diseases Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, Emily Shah, MPH, CIC, UT MD Anderson Cancer Center, HOUSTON, TX, Linda Graviss, BS, CIC, MT, Infectious Diseases, Infection Control, Employee Health, MD Anderson Cancer Center, Houston, TX, Issam Raad, MD, Department of Infectious Diseases, University of Texas MD Anderson Cancer Center, Houston, TX and Roy Chemaly, MD, MPH, The University of Texas MD Anderson Cancer Center, Houston, TX

Disclosures:

D. P. Kontoyiannis, Merck: Consultant , Research support and Speaker honorarium . Pfizer: Consultant , Research support . Astellas: Consultant , Research support and Speaker honorarium . Gilead: Speaker's Bureau , Speaker honorarium . F2G Inc: Speaker's Bureau , Speaker honorarium . Cidara Inc: Speaker's Bureau , Speaker honorarium . Jazz Pharmaceuticals: Speaker's Bureau , Speaker honorarium .

E. Shah, None

L. Graviss, None

I. Raad, The University of Texas MD Anderson Cancer Center: Shareholder , Licensing agreement or royalty . The Unversity of Texas MD Anderson Cancer Center: Shareholder , Dr. Raad is a co-inventor of the Nitroglycerin-Citrate-Ethanol catheter lock solution technology which is owned by the University of Texas MD Anderson Cancer Center (UTMDACC) and has been licensed to Novel Anti-Infective Technologies LLC, in which UTMDACC and Licensing agreement or royalty .

R. Chemaly, None

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