- Associated Press - Wednesday, April 16, 2014

NEW ORLEANS (AP) - Five very sick children died after a fungus apparently brought into a New Orleans hospital on sheets and other linens made them sicker, federal and state investigators said Wednesday.

The children died in 2008 and 2009, according to the Centers for Disease Control and Prevention. Although an article scheduled for publication in a European medical journal said severe infections are nearly all fatal, officials said the fungus was not the primary cause of any death.

“The deaths were not because of the infection; they were because of the primary diagnosis,” said Brian Landry, spokesman for Children’s Hospital of New Orleans. The fungal infection would have been noted as a contributing factor, he said.

Investigators say the fungus, identified as Rhizopus delemar, is extremely common and dangerous only to people with weak immune systems. In them, it can get into the body through the skin and spread incredibly quickly; infected tissue must be cut away.

A spot the size of a quarter under 13-year-old Zachary Malik Tyler’s arm grew to the size of a baseball within 24 hours in March 2009, according to a lawsuit filed in 2010 by his parents, Stephen Tyler and Dorothy Malik. It said he had 20 operations to remove infected tissue in the two months between the time his infection was diagnosed and his death.

Their suit contends that doctors should have had the spot biopsied the day it was noticed rather than two days later. The couple also sued the linen company, TLC Services Inc.

Landry and David Batt, who represent TLC, said they cannot talk about pending litigation. Harry Widmann, who represents Tyler and Malik, wrote in an email that he and his clients have no comment at this time.

The Associated Press obtained an early copy of the article, detailing the findings of a CDC study, scheduled for the May issue of the Pediatric Infectious Disease Journal, the official journal of the European Society for Paediatric Infectious Diseases. It did not identify the hospital, but Children’s Hospital officials confirm the cases occurred there.

Children’s Hospital quickly changed linen providers and now sterilizes all linens used in intensive care, Landry said.

Four children other than Zachary developed symptoms more than two weeks after being hospitalized, according to a CDC report also obtained by the AP. They were a newborn who developed an infection in August 2008, another newborn in March 2009 and two girls, aged 10 and 11, who showed symptoms in June 2009.

The five spent time on seven wards, according to the journal article. None was in the same ward at the same time as any other, nor was there any single common location. Skin symptoms suggested they had touched something contaminated.

“We considered items that come in contact with patients’ skin, including medical devices, equipment, lotions, soaps, bathing products, and topical medications and applications, but the only such exposure all the case-patients had in common was hospital linens” - sheets, blankets, pillowcases, towels, washcloths and patient gowns, the journal article said.

It said the fungus was found on 42 percent of other checked items that had touched clean linen and only one item not related to linen.

Calls to other area hospitals did not turn up infections, Louisiana state epidemiologist Dr. Raoult Ratard, said in an interview.

“This infection is well-known among oncologists, transplant centers and medical facilities dealing with these severe immuno-deficient patients,” he wrote in a later email.

Dr. Tom Chiller, senior author of the CDC report, said there’s little data about fungal infections but they seem to be rising.

“It makes sense that as more and more people are on immunosuppressive drugs for more and more conditions, including transplants, more and more people are at risk,” he said. “We need to be aggressive in how we approach those people and try to protect them.”

And, he said, “I think the hospital was incredibly proactive,” calling in state and federal investigators.

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