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Nov 01, 2024

Guidance for Healthcare-Associated Mold Outbreaks | Fungal Diseases | CDC

Invasive mold infections can affect people with weakened immune systems, such as organ or stem cell transplant recipients. Although rare, mold outbreaks can occur in healthcare facilities causing

Invasive mold infections can affect people with weakened immune systems, such as organ or stem cell transplant recipients. Although rare, mold outbreaks can occur in healthcare facilities causing severe illness and death among patients.

Two common types of healthcare-associated invasive mold infections include mucormycosis and aspergillosis. Depending on the organism and patient characteristics, death rates can be more than 50%.

Healthcare facilities can take special precautions to help prevent patients from getting mold infections, including:

For additional protection, patients with high risk for infection may be prescribed prevenatitve antifungal medication and/or placed in positive pressure rooms.

Notify the local or state health department immediately when healthcare personnel suspect a mold infection cluster. Do not wait for laboratory confirmation to report a cluster or outbreak. Laboratory confirmation for some molds takes longer than it would for many other fungi.

Consider reporting and beginning investigations for suspected mold outbreaks if either of the following are observed:

Determining whether a cluster of mold infections (i.e., a suspected outbreak) represents a true outbreak can be difficult for several reasons:

Notify patients at highest risk for severe mold infections as soon as a cluster or outbreak are suspected. Patients at high risk include transplant recipients and patients with hematologic malignancies.

Early patient notification about a suspected outbreak can help:

Remind patients, visitors, and clinicians about the importance of proper infection control measures and how to reduce the risk of getting sick.

Patient notification can occur in a number of ways, including verbal communication by healthcare providers based on a healthcare facility–developed template. For more information and examples of ways to notify patients, visit CDC's Patient Notification Toolkit.

If performing environmental sampling, a sampling strategy developed by an industrial hygienist who works in healthcare settings is recommended.

Environmental sampling is challenging because mold can be found anywhere. Detecting a certain mold species or level of mold spores in one location or on one object does not by itself indicate that it is the source of infections. Absence of mold in a location or on an object does not necessarily rule it out as mold can be found intermittently and across multiple sources.

CDC works closely with local and state health departments to help identify, investigate, and contain fungal outbreaks. Public health officials, healthcare facilities, and laboratories can request CDC assistance with fungal diagnostics and epidemiologic investigations by emailing [email protected].

Consultations with CDC on suspected outbreaks can be more effective if the healthcare facility or health department shares a brief summary beforehand.

If possible, summaries should include the following:

For infection preventionists to assess laundry management practices at laundry facilities and health care facilities

An article describing strategies to prevent contamination of healthcare linens, which has been linked to healthcare-associated mold infections