Scraping Away the Mystery of Mold

My home institution's battle with Mucor mold infections is thankfully largely over and they are again safely transplanting organs into some of the sickest individuals in the world. The results of the CDC's investigation of the entire episode, which amounted to 4 infections (which may not even be more than would be expected in this type of patient population), are beginning to emerge and an important preliminary finding has been released.

According to press reports the 4 patients differed in their mode of acquisition of the mold. This is a noteworthy finding because it confirms that there was no point source for all the cases such as linens or bandages (previously linked to hospital-based Mucor cases).  It has been reported that 2 cases were inhalational, one was disseminated, and one was inoculated via the skin. As I have said on numerous occasions, mold is abundant in the environment and only poses a health risk to those that are immunocompromised. People can contract mold infections by inhaling spores, having the mold directly inoculated into a skin break, ingesting it (some outbreaks have been tied to contaminated infant feeding solutions), and injecting it into their veins. That these patient had differing modes of acquisition doesn't bear on the ultimate environmental source of the mold in the hospital, an important aspect of the investigation results yet to come.

I am currently attending a national infectious disease meeting and have listened to several lectures on mold rates in major hospitals and it is even more clear to me now that these 4 cases, though regrettable, are within the normal ranges to be expected at a major transplant center (despite what trial lawyers and rabble-rousers may believe). That my institution went through a Herculean process and basically had portions of their transplant list poached by a rival and declined organs during their unprecedented voluntary shut down, speaks to the high standards adhered to.