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Title: Outbreaks of Fungal Infections in Hospitals: Epidemiology, Detection, and Management.
Austin Authors: Douglas, Abby P;Stewart, Adam G;Halliday, Catriona L;Chen, Sharon C-A
Affiliation: National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.;Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia.;Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC 3000, Australia.
Centre for Clinical Research, Faculty of Medicine, Royal Brisbane and Women's Hospital Campus, The University of Queensland, Herston, QLD 4006, Australia.
Infectious Diseases
Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Sydney, NSW 2145, Australia.;Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
Issue Date: 29-Oct-2023
Date: 2023
Publication information: Journal of Fungi (Basel, Switzerland) 2023-10-29; 9(11)
Abstract: Nosocomial clusters of fungal infections, whilst uncommon, cannot be predicted and are associated with significant morbidity and mortality. Here, we review reports of nosocomial outbreaks of invasive fungal disease to glean insight into their epidemiology, risks for infection, methods employed in outbreak detection including genomic testing to confirm the outbreak, and approaches to clinical and infection control management. Both yeasts and filamentous fungi cause outbreaks, with each having general and specific risks. The early detection and confirmation of the outbreak are essential for diagnosis, treatment of affected patients, and termination of the outbreak. Environmental sampling, including the air in mould outbreaks, for the pathogen may be indicated. The genetic analysis of epidemiologically linked isolates is strongly recommended through a sufficiently discriminatory approach such as whole genome sequencing or a method that is acceptably discriminatory for that pathogen. An analysis of both linked isolates and epidemiologically unrelated strains is required to enable genetic similarity comparisons. The management of the outbreak encompasses input from a multi-disciplinary team with epidemiological investigation and infection control measures, including screening for additional cases, patient cohorting, and strict hygiene and cleaning procedures. Automated methods for fungal infection surveillance would greatly aid earlier outbreak detection and should be a focus of research.
DOI: 10.3390/jof9111059
ORCID: 0000-0002-0301-7110
Journal: Journal of Fungi (Basel, Switzerland)
PubMed URL: 37998865
ISSN: 2309-608X
Type: Journal Article
Subjects: fungi
infection prevention
whole genome sequencing
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