title: Fusariosis associated with pathogenic fusarium species colonization of a hospital water system: a new paradigm for the epidemiology of opportunistic mold infections.
abstract: We sought the reservoir of Fusarium species in a hospital with cases of known fusarial infections. Cultures of samples from patients and the environment were performed and evaluated for relatedness by use of molecular methods. Fusarium species was recovered from 162 (57%) of 283 water system samples. Of 92 sink drains tested, 72 (88%) yielded Fusarium solani; 12 (16%) of 71 sink faucet aerators and 2 (8%) of 26 shower heads yielded Fusarium oxysporum. Fusarium solani was isolated from the hospital water tank. Aerosolization of Fusarium species was documented after running the showers. Molecular biotyping revealed multiple distinct genotypes among the isolates from the environment and patients. Eight of 20 patients with F. solani infections had isolates with a molecular match with either an environmental isolate (n=2) or another patient isolate (n=6). The time interval between the 2 matched patient-environment isolates pairs was 5 and 11 months, and 2, 4, and 5.5 years for the 3 patient-patient isolate pairs. The water distribution system of a hospital was identified as a reservoir of Fusarium species.
authors.affiliation: Myeloma and Transplantation Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. anaissieeliasj@exchange.uams.edu
authors.forename: E J
authors.initials: EJ
authors.lastname: Anaissie
authors.forename: R T
authors.initials: RT
authors.lastname: Kuchar
authors.forename: J H
authors.initials: JH
authors.lastname: Rex
authors.forename: A
authors.initials: A
authors.lastname: Francesconi
authors.forename: M
authors.initials: M
authors.lastname: Kasai
authors.forename: F M
authors.initials: FM
authors.lastname: Müller
authors.forename: M
authors.initials: M
authors.lastname: Lozano-Chiu
authors.forename: R C
authors.initials: RC
authors.lastname: Summerbell
authors.forename: M C
authors.initials: MC
authors.lastname: Dignani
authors.forename: S J
authors.initials: SJ
authors.lastname: Chanock
authors.forename: T J
authors.initials: TJ
authors.lastname: Walsh
mesh_terms: D000391:Air Microbiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis; D005670:Fusarium / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D009181:Mycoses / Q000453:epidemiology* / Q000382:microbiology; D009894:Opportunistic Infections / Q000453:epidemiology* / Q000382:microbiology; D014871:Water Microbiology
chemical_list: D004269:DNA, Bacterial