Invasive mould infections in patients from floodwater-damaged areas after hurricane Harvey – a closer look at an immunocompromised cancer patient population

Details

• Alternative Title:
  J Infect
• Personal Author:
  Wurster, Sebastian ; Paraskevopoulos, Timotheos ; Toda, Mitsuru ; Jiang, Ying ; Tarrand, Jeffrey J. ; Williams, Samantha ; Chiller, Tom M. ; Jackson, Brendan R. ; Kontoyiannis, Dimitrios P.
• Description:
  Objectives:
  
  Extensive floodwater damage following hurricane Harvey raised concerns of increase in invasive mould infections (IMIs), especially in immunocompromised patients. To more comprehensively characterize the IMI landscape pre- and post-Harvey, we used a modified, less restrictive clinical IMI (mcIMI) definition by incorporating therapeutic-intent antifungal drug prescriptions combined with an expanded list of host and clinical features.
  
  Methods:
  
  We reviewed 103 patients at MD Anderson Cancer Center (Houston, Texas), who lived in Harvey-affected counties and had mould-positive cultures within 12 months pre-/post-Harvey (36 and 67 patients, respectively). Cases were classified as proven or probable IMI (EORTC/MSG criteria), mcIMI, or colonization/contamination. We also compared in-hospital mortality and 42- day survival outcomes of patients with mcIMI pre-/post-Harvey.
  
  Results:
  
  The number of patients with mould- positive cultures from Harvey-affected counties almost doubled from 36 pre- Harvey to 67 post- Harvey (p < 0.01). In contrast, no significant changes in (mc)IMI incidence post-Harvey nor changes in the aetiological mould genera were noted. However, patients with mcIMIs from flood affected areas had significantly higher in-hospital mortality (p = 0.01).
  
  Conclusions:
  
  We observed increased colonization but no excess cases of (mc)IMIs in immunosuppressed cancer patients from affected areas following a large flooding event such as hurricane Harvey.
  
  
• Subjects:
  Antifungal Agents Cyclonic Storms Floods Fungi Humans Immunocompromised Host Neoplasms
• Keywords:
  Aspergillosis Disease Surveillance Floodwater Damage Invasive Mould Infections Mortality Mould Exposure Mucormycosis
• Source:
  J Infect. 84(5):701-709
• Pubmed ID:
  35288118
• Pubmed Central ID:
  PMC11018252
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  84
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5d29169ef1edebea074fde640ab5a481cbadba98a07b07601599ef5cd022cc6b
• Download URL:
  https://stacks.cdc.gov/view/cdc/154392/cdc_154392_DS1.pdf
• File Type:
  [PDF - 761.96 KB ]