Mikosz Christina A, Smith Rachel M, Kim Moon, Tyson Clara, Lee Ellen H, Adams Eleanor, Straif-Bourgeois Susanne, Sowadsky Rick, Arroyo Shannon, Grant-Greene Yoran, Duran Julie, Vasquez Yvonne, Robinson Byron F, Harris Julie R, Lockhart Shawn R, Török Thomas J, Mascola Laurene, Park Benjamin J
Emerg Infect Dis. 2014 Feb;20(2):248-56. doi: 10.3201/eid2002.131257.
Fungal endophthalmitis is a rare but serious infection. In March 2012, several cases of probable and laboratory-confirmed fungal endophthalmitis occurring after invasive ocular procedures were reported nationwide. We identified 47 cases in 9 states: 21 patients had been exposed to the intraocular dye Brilliant Blue G (BBG) during retinal surgery, and the other 26 had received an intravitreal injection containing triamcinolone acetonide. Both drugs were produced by Franck's Compounding Lab (Ocala, FL, USA). Fusarium incarnatum-equiseti species complex mold was identified in specimens from BBG-exposed case-patients and an unopened BBG vial. Bipolaris hawaiiensis mold was identified in specimens from triamcinolone-exposed case-patients. Exposure to either product was the only factor associated with case status. Of 40 case-patients for whom data were available, 39 (98%) lost vision. These concurrent outbreaks, associated with 1 compounding pharmacy, resulted in a product recall. Ensuring safety and integrity of compounded medications is critical for preventing further outbreaks associated with compounded products.
真菌性眼内炎是一种罕见但严重的感染。2012年3月，全国报告了几例在侵入性眼科手术后发生的疑似及实验室确诊的真菌性眼内炎病例。我们在9个州确认了47例病例：21例患者在视网膜手术期间接触了眼内染料亮蓝G（BBG），另外26例接受了含有曲安奈德的玻璃体内注射。这两种药物均由弗兰克配制实验室（美国佛罗里达州奥卡拉）生产。在接触BBG的病例患者标本及一支未开封的BBG小瓶中鉴定出了肉色镰刀菌-多型镰刀菌种复合体霉菌。在接触曲安奈德的病例患者标本中鉴定出了夏威夷双极霉霉菌。接触这两种产品中的任何一种是与病例状态相关的唯一因素。在有数据可查的40例病例患者中，39例（98%）视力丧失。这些与1家配制药房相关的同时爆发事件导致了产品召回。确保配制药品的安全性和完整性对于预防与配制产品相关的进一步爆发至关重要。
