Evidence map›Paper›PMID 32528999›Full record

ArticleOpen forum infectious diseases2020

Long-term Outcomes of Patients With Fungal Infections Associated With Contaminated Methylprednisolone Injections.

Anurag N Malani, Carol A Kauffman, Robert Latham, Sheree Peglow, Christopher S Ledtke, Thomas M Kerkering, David H Kaufman, Patricia F Triplett, Patty W Wright, Karen C Bloch and 5 more

Open access · goldAbstract read
In one paragraph

Article in Open forum infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 1 country.

Anurag N MalaniSt Joseph Mercy Hospital, Ann Arbor, Michigan, USA.
Carol A KauffmanVA Ann Arbor Healthcare System and University of Michigan Medical School, Ann Arbor, Michigan, USA.
Robert LathamSt. Thomas Medical Center and Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Sheree PeglowElkhart General Hospital, Elkhart, Indiana, USA.
Christopher S LedtkeMunson Medical Center, Traverse City, Michigan, USA.
Thomas M KerkeringVirginia Tech Carilion School of Medicine, Roanoke, Virginia, USA.
David H KaufmanInspira Health Network, Vineland, New Jersey, USA.
Patricia F TriplettUniversity of North Carolina Health Care, High Point, North Carolina, USA.
Patty W WrightVanderbilt University School of Medicine, Nashville, Tennessee, USA.
Karen C BlochVanderbilt University School of Medicine, Nashville, Tennessee, USA.
Orion McCotterCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Mitsuru TodaCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Brendan R JacksonCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Peter G PappasUniversity of Alabama at Birmingham, Birmingham, Alabama, USA.
Tom M ChillerCenters for Disease Control and Prevention, Atlanta, Georgia, USA.
Centers for Disease Control and Prevention · USVanderbilt University · USCarilion Clinic · USElkhart Clinic · USHigh Point University · USInspira Medical Center Vineland · USMunson Medical Center · USTrinity Health Ann Arbor Hospital · USUniversity of Alabama at Birmingham · USUniversity of Michigan–Ann Arbor · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe largest health care-associated infection outbreak in the United States occurred during 2012-2013. Following injection of contaminated methylprednisolone, 753 patients developed infection with a dematiaceous mold,

methodsThis retrospective cohort study of 440 of a total of 753 patients with proven or probable

resultsAmong the 440 patients, 223 (51%) had spinal/paraspinal infection, 82 (19%) meningitis/stroke, 123 (28%) both, and 12 (3%) osteoarticular infection. Of 82 patients with meningitis/stroke, 18 (22%) died; among those surviving, 87% were cured at 12 months. Only 7 (3%) of 223 patients with spinal/paraspinal infection died, but at 12 months, 68% had persistent or worsening pain and only 47% were cured. For the 123 patients with both meningitis/stroke and spinal/paraspinal infection, 10 (8%) died, pain persisted in 72%, and 52% were cured at 12 months. Only 37% of those with osteoarticular infection were cured at 12 months. Adverse events from antifungal therapy were noted at 6 weeks in 71% of patients on voriconazole and 81% on amphotericin B.

conclusionsFungal infections related to contaminated methylprednisolone injections culminated in death in 8% of patients. Persistent pain and disability were seen at 12 months in most patients with spinal/paraspinal infections.

Indexed as

amphotericin BarachnoiditisExserohilum rostratummeningitismethylprednisolone; paraspinal infectionspinal infectionvoriconazole

Identifiers

PMID32528999
PMCPMC7275232
OpenAlexW3023719555

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.