Evidence map›Paper›PMID 36320193›Full record

ArticleOpen forum infectious diseases2022

Investigation of a Prolonged and Large Outbreak of Healthcare-Associated Mucormycosis Cases in an Acute Care Hospital-Arkansas, June 2019-May 2021.

Alexander Jordan, Allison E James, Jeremy A W Gold, Karen Wu, Janet Glowicz, Frankie Wolfe, Keyur Vyas, Anastasia Litvintseva, Lalitha Gade, Hazel Liverett and 13 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open forum infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Review
  2. Active Surveillance for Invasive Mold Disease - Four Hospitals, Atlanta, Georgia, 2020-2024.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2026
    Article
  3. Article
  4. Article
  5. Review
  6. Textiles as fomites in the healthcare system.Applied microbiology and biotechnology · 2023
    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

23 authors.

Alexander JordanMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-7834-866X
Allison E JamesEpidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Jeremy A W GoldMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Karen WuMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Janet GlowiczPrevention and Response Branch, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Frankie WolfeMedical Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Keyur VyasMedical Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Anastasia LitvintsevaMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Lalitha GadeMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Hazel LiverettMedical Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Mary AlversonMedical Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Mary BurgessMedical Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Amy WilsonMedical Center, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Ruoran LiEpidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Isaac BenowitzPrevention and Response Branch, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Trent GulleyArkansas Department of Health, Little Rock, Arkansas, USA.
Naveen PatilArkansas Department of Health, Little Rock, Arkansas, USA.
Rohan ChakravortyArkansas Department of Health, Little Rock, Arkansas, USA.
Winston ChuArkansas Department of Health, Little Rock, Arkansas, USA.
Atul KothariArkansas Department of Health, Little Rock, Arkansas, USA.
Brendan R JacksonMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Kelley GarnerArkansas Department of Health, Little Rock, Arkansas, USA.
Mitsuru TodaMycotic Diseases Branch, Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Outbreaks of healthcare-associated mucormycosis (HCM), a life-threatening fungal infection, have been attributed to multiple sources, including contaminated healthcare linens. In 2020, staff at Hospital A in Arkansas alerted public health officials of a potential HCM outbreak. Methods: We collected data on patients at Hospital A who had invasive mucormycosis during January 2017-June 2021 and calculated annual incidence of HCM (defined as mucormycosis diagnosed within ≥7 days after hospital admission). We performed targeted environmental assessments, including linen sampling at the hospital, to identify potential sources of infection. Results: During the outbreak period (June 2019-June 2021), 16 patients had HCM; clinical features were similar between HCM patients and non-HCM patients. Hospital-wide HCM incidence (per 100 000 patient-days) increased from 0 in 2018 to 3 in 2019 and 6 in 2020. For the 16 HCM patients, the most common underlying medical conditions were hematologic malignancy (56%) and recent traumatic injury (38%); 38% of HCM patients died in-hospital. Healthcare-associated mucormycosis cases were not epidemiologically linked by common procedures, products, units, or rooms. At Hospital A and its contracted offsite laundry provider, suboptimal handling of laundered linens and inadequate environmental controls to prevent mucormycete contamination were observed. We detected Conclusions: We describe the largest, single-center, HCM outbreak reported to date. Our findings underscore the importance of hospital-based monitoring for HCM and increased attention to the safe handling of laundered linens.

Indexed as

healthcare-associated infectionshealthcare linensmucormycosisoutbreak investigation

Identifiers

PMID36320193
PMCPMC9605704

What OpenQuestion holds

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Registered trials

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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.