An investigation of Aspergillus cardiac surgical site infections in 3 pediatric patients.
BACKGROUND
Within a 3-month period, 3 pediatric patients at our hospital developed Aspergillus surgical site infections after undergoing cardiac surgery.


METHODS
A multidisciplinary team conducted an epidemiologic review of the 3 patients and their infections, operative and postoperative patient care delivery, and routine maintenance of hospital equipment and air-filtration systems and investigated potential environmental exposures within the hospital that may have contributed to the development of these infections.


RESULTS
Review of the patients and their infections, operative and postoperative patient care delivery, and routine maintenance did not reveal a source for infection. Inspection of operating room (OR) facilities identified several areas in need of repair. Of the 58 samples of air and equipment exhaust in the ORs and patient care areas, 11 revealed 2 to 4 colony-forming units of various Aspergillus species per cubic meter of air, and the remaining 47 samples were negative for Aspergillus. Eighty-three samples of surfaces and equipment water reservoirs were obtained from the OR and patient care areas. One culture of a soiled liquid nitrogen tank housed between the 2 cardiac ORs revealed 13 colony-forming units of Aspergillus.


CONCLUSIONS
No definitive source was identified, although a soiled liquid nitrogen tank contaminated with Aspergillus and kept near the OR was found and could have been a possible source.
Kronman
Matthew P
MP
Department of Pediatrics, University of Washington, Children's Hospital and Regional Medical Center, Seattle, WA 98105, USA.
Baden
Harris P
HP
Jeffries
Howard E
HE
Heath
Joan
J
Cohen
Gordon A
GA
Zerr
Danielle M
DM
D000391:Air Microbiology; D001228:Aspergillosis / Q000209:etiology*; D006348:Cardiac Surgical Procedures; D002675:Child, Preschool; D003428:Cross Infection / Q000209:etiology* / Q000382:microbiology*; D004866:Equipment Contamination; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D013530:Surgical Wound Infection / Q000382:microbiology*