title: Cardiothoracic surgical site phaeohyphomycosis caused by Bipolaris mould, multiple US states, 2008-2013: a clinical description.
abstract: Bipolaris mould surgical site infections (SSIs) are exceedingly rare. We describe 21 cases of Bipolaris SSIs in pediatric and adult cardiothoracic surgery patients at ten hospitals in Texas, Arkansas, and Florida during 2008-2013. Median case-patient age was 55 years (range: 3 days-82 years), and 19 (90%) were male. Ten (48%) had coronary artery bypass or valve surgery, and seven (33%) had heart transplantation. Fifteen (71%) had more than one cardiothoracic procedure (median: 3, range: 1-11). Thirteen (62%) case-patients (all 5 pediatric patients, and 8 (50%) of 16 adult patients) had delayed sternal closure (chest closed >1 day [median = 8 days; range: 2-22] following the initial cardiothoracic procedure). Thirteen (62%) had mediastinitis. Median time from initial surgery to positive Bipolaris culture was 20 days (range: 6-497). Sixteen (76%) case-patients died.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia fco6@cdc.gov.
authors.forename: Snigdha
authors.initials: S
authors.lastname: Vallabhaneni
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Anne E
authors.initials: AE
authors.lastname: Purfield
authors.affiliation: Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kaitlin
authors.initials: K
authors.lastname: Benedict
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Ulzii
authors.initials: U
authors.lastname: Luvsansharav
authors.affiliation: Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Shawn R
authors.initials: SR
authors.lastname: Lockhart
authors.affiliation: Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Cau D
authors.initials: CD
authors.lastname: Pham
authors.affiliation: Texas Department of State Health Services, Austin, Texas.
authors.forename: Neil
authors.initials: N
authors.lastname: Pascoe
authors.affiliation: Texas Department of State Health Services, Austin, Texas.
authors.forename: Gary
authors.initials: G
authors.lastname: Heseltine
authors.affiliation: Dallas County Health and Human Services, Dallas, Texas.
authors.forename: Wendy
authors.initials: W
authors.lastname: Chung
authors.affiliation: Dallas County Health and Human Services, Dallas, Texas.
authors.forename: Emily
authors.initials: E
authors.lastname: Hall
authors.affiliation: Scott and White Hospital, Temple, Texas.
authors.forename: Karen B
authors.initials: KB
authors.lastname: Brust
authors.affiliation: Scott and White Hospital, Temple, Texas.
authors.forename: Charlotte F
authors.initials: CF
authors.lastname: Wheeler
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Alison Laufer
authors.initials: AL
authors.lastname: Halpin
authors.affiliation: Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001131:Arkansas / Q000453:epidemiology; D001203:Ascomycota / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D060446:Phaeohyphomycosis / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology*; D017678:Sex Distribution; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology*; D016019:Survival Analysis; D013781:Texas / Q000453:epidemiology; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D055815:Young Adult
keywords: Bipolaris; cardiothoracic surgery; fungal; mould; phaeohyphomycosis; surgical site infections