Volume 26, Number 9—September 2020
Synopsis
Saprochaete clavata Outbreak Infecting Cancer Center through Dishwasher
Estelle Menu, Alexis Criscuolo, Marie Desnos-Ollivier, Carole Cassagne, Evelyne D’Incan, Sabine Furst, Stéphane Ranque, Pierre Berger, and Françoise Dromer
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. | |||||||||
Page created: June 16, 2020
Page updated: August 18, 2020
Page reviewed: August 18, 2020
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