In the last two weeks, UPMC Presbyterian in Pittsburgh shut down its cardiothoracic intensive care unit after a patient developed a fungal infection and investigators found mold in the area. At that time, the hospital noted one patient had a fungal infection in an external wound. The story grew more complicated over the last week.
Here are seven things to know about the mold problem at UPMC Presbyterian.
1. UPMC Presbyterian closed the 20-bed cardiothoracic ICU Sept. 3 and relocated patients after discovering one patient got an infection from mold, according to the Pittsburgh Post-Gazette. That patient is currently "seriously ill with a fungal infection called rhizopus," Tami Minnier, RN, MSN, UPMC's chief quality officer, shared in a blog post, and the patient is still hospitalized at UPMC Presbyterian and has a poor prognosis.
2. Investigators found mold behind a wall of one room in the ICU and also in toilets of other rooms in the ICU.
3. As hospital staff reviewed patient records as part of the mold investigation, they discovered that two previous transplant patients who had stayed in that ICU room had fungal infections possibly linked to the mold, according to Ms. Minnier, and died. The cause of death was not specified, but the infections contracted were lichtheimia (in a patient in October 2014) and rhizomucor (in a patient in June 2015).
4. On Sept. 17, a liver transplant patient at UPMC Montefiore, which is adjacent to UPMC Presbyterian, died. This patient appears to have a fungal infection similar to the other affected patients, according to a blog post written by Steven Shapiro, MD, the chief medical and scientific officer of UPMC. This patient was not in the temporarily closed ICU where they other patients had stayed.
5. As a precaution, all of the transplant patients in UPMC Presbyterian-Montefiore are now on antifungal medication, even though they do not have fungal infection. "This prophylactic treatment is intended to protect them until we find and fix the source of the problem," Dr. Shapiro wrote.
6. The reason these patients' infections weren't connected sooner is because they are different, though related, fungal infections, according to the Post-Gazette. The fungi that caused these infections are common on plants, like vegetables and fruit that has gone bad, and do not usually negatively affect healthy humans. All affected patients were transplant patients, meaning they were immunosuppressed. "Unless you are severely immunocompromised, you are completely safe," Ms. Minnier told Trib Live. In her blog post, she wrote, "We do not believe that the mold in the toilets was the same kind as in the patients."
7. UPMC's infection prevention experts are working with the Allegheny County Health Department, the Pennsylvania Department of Health, the Joint Commission and the CDC to solve the problem. In addition to putting transplant patients on antifungal medication, the hospital is also taking the following steps:
- Consulting with an international mold and hospital environment specialist, Andrew J. Streifel
- Consulting with the Center for Organ Recovery and Education
- Investigating commonalities between the four affected patients
- Monitoring air quality to detect mold and dust
- Replacing microfilters in the air handling units as a precaution
- Using UV disinfecting robots in all ICUs