Volume 26, Number 9—September 2020
Synopsis
Saprochaete clavata Outbreak Infecting Cancer Center through Dishwasher
Table
Characteristics of patients with a culture positive for Saprochaete clavata in Marseille, France, February 2016–December 2017*
Characteristic | Patient no. |
||||||||
---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | |
Age, y | 58 | 38 | 45 | 66 | 57 | 68 | 65 | 56 | 68 |
Sex | M | F | M | F | M | M | F | M | M |
Hospitalization ward |
H |
H |
T |
ICU |
T |
H |
T |
T |
H |
Immune status | |||||||||
Underlying disease | Lymphoma | AML | MDS | Lymphoma | CLL | AML | ALL | AML | AML |
Lymphocyte count, G/L | <0.1 | 0.1 | 5.6 | 0.2 | 0.1 | 0.1 | 0.8 | 0.1 | 0.1 |
Severe neutropenia, <500 /mm3 | Yes | Yes | No | Yes | Yes | Yes | Yes | Yes | Yes |
Duration of neutropenia at time of positive culture, d | 6 | 51 | 0 | 4 | 36 | 27 | 0 | 21 | 21 |
BMT | Yes | No BMT | Yes | No BMT | Yes | No BMT | Yes | Yes | Yes |
Days from BMT to first positive
culture |
9 |
90 |
75 |
61 |
3 |
>90 |
|||
Clinical signs at the time of positive culture | |||||||||
Fever, temperature >38°C | Yes | Yes | Yes | Yes | NA | Yes | NA | Yes | Yes |
Digestive symptoms | Yes | Yes | NA | NA | NA | NA | Yes | Yes | Yes |
Diarrhea | Yes | NA | NA | NA | NA | Yes | Yes | ||
Constipation | NA | Yes | NA | NA | NA | NA | NA | Yes | |
Pulmonary symptoms | NA | Yes | Yes | NA | NA | NA | Yes | NA | Yes |
Skin lesions |
NA |
NA |
NA |
Yes |
Yes |
NA |
Yes |
NA |
NA |
Positive culture results | |||||||||
Date of first positive culture | 2016 Feb 3 | 2017 Jan 16 | 2017 Jan 18 | 2017 Feb 26 | 2017 Apr 17 | 2017 Jun 29 | 2017 Dec 5 | 2017 Dec 10 | 2017 Dec 29 |
Days after admission | 16 | 51 | 6 | 14 | 80 | 27 | 68 | 20 | 21 |
No. positive samples | 1 | 1 | 2 | 7 | 5 | 9 | 1 | 10 | 5 |
Blood | 1 | 1 | None | 5 | 4 | 9 | 1 | 9 | 5 |
Respiratory tract | None | None | 2 | 2 | 1 | None | None | None | None |
Stool, rectal swab |
None |
None |
None |
None |
None |
None |
None |
1 |
None |
Outcome | |||||||||
Death within 90 d | No | Yes | Yes | Yes | No | Yes | Yes | No | No |
Days after first positive culture |
DNA |
12 |
57 |
7 |
DNA |
4 |
6 |
DNA |
DNA |
Treatment | |||||||||
Venous access | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Echinocandins | Micafungin | NP | NP | NP | NP | NP | Caspo | NP | NP |
Azoles | NP | PCZ | NP | NP | VCZ | PCZ | VCZ | VCZ | VCZ, PCZ |
Cytarabine | Yes | Yes | NP | NP | Yes | Yes | Yes | Yes | |
Ibrutinib | NP | NP | NP | Yes | |||||
Apheresis platelet concentrates |
NP |
Yes |
NP |
NP |
Yes |
Yes |
Yes |
Yes |
Yes |
*ALL, acute lymphoblastic leukemia; ANL, acute myeloid leukemia; BMT, bone marrow transplant; Caspo, caspofungin; CLL, chronic lymphocytic leukemia; DNA, does not apply; H, hematology; ICU, intensive care unit; MDS, myelodysplastic syndromes; NA, not available; NP, not prescribed; PCZ, posaconazole; T, stem-cell transplant; VCZ, voriconazole. †Bronchoalveolar lavage, tracheal aspirate. |