title: Surveillance of patients identified with fungal mold at a public academic medical center.
abstract: BACKGROUND
  This study describes the epidemiology of patients with fungal mold infection or colonization at a large academic medical center during a period of ongoing construction of a new hospital building.
  
  
  METHODS
  This is an observational retrospective cohort study performed at a public academic hospital. We performed focused medical record review of all patients with fungal mold isolated on microbiologic culture over a 3-year period from May 2009 through April 2012. We established case definitions by modifying criteria used in previously published studies. We established 4 categories for invasiveness: proven invasive fungal disease (IFD), probable IFD, clinical infection not meeting IFD criteria, or colonization/contamination. We also established 3 categories for association with our health care facilities: health care-associated hospital onset (HO), health care-associated community onset (HACO), or community associated (CA).
  
  
  RESULTS
  Of the 188 cases included in the study, 15 (7.9%) and 23 (12.2%) met criteria for proven and probable IFD, respectively. Of the cases, 114 (60.6%) represented contamination or colonization, and 36 (19.1%) had clinical infection not meeting IFD criteria. Epidemiologically, 46 (24.5%) cases were HO, 42 (22.3%) cases were HACO, and 100 (53.2%) cases were CA.
  
  
  CONCLUSIONS
  The surveillance methods we established were helpful for characterizing and monitoring fungal mold infections at the study institution.
authors.affiliation: Department of Medicine-Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Priti
authors.initials: P
authors.lastname: Patwari
authors.affiliation: Department of Medicine-Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: James
authors.initials: J
authors.lastname: Cutrell
authors.affiliation: Division of Infectious Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Archana
authors.initials: A
authors.lastname: Bhaskaran
authors.affiliation: Department of Infection Prevention, Parkland Health and Hospital System, Dallas, TX.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Trevino
authors.affiliation: Department of Medicine-Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX; Department of Infection Prevention, Parkland Health and Hospital System, Dallas, TX. Electronic address: pranavi.sreeramoju@utsouthwestern.edu.
authors.forename: Pranavi
authors.initials: P
authors.lastname: Sreeramoju
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D062665:Epidemiological Monitoring; D005260:Female; D005658:Fungi / Q000145:classification* / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
keywords: Fungal infection; Health care–associated infection; Infection control; Mold infection