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Outbreak of fungal infections associated with contaminated methylprednisolone acetate: an update

April C Pettit1, Anurag N Malani

  • 1Department of Medicine, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA, april.pettit@vanderbilt.edu.

Current Infectious Disease Reports
|November 24, 2014
PubMed

Insights

A 2012 fungal outbreak linked to contaminated methylprednisolone acetate (MPA) highlighted the need for better pharmaceutical compounding regulations. Public health responses were crucial in limiting further infections from Exserohilum rostratum.

Area of Science:

  • Mycology
  • Epidemiology
  • Public Health

Background:

  • An unprecedented outbreak of fungal infections occurred in September 2012.
  • The infections were linked to preservative-free, injectable methylprednisolone acetate (MPA).
  • Exserohilum rostratum was identified as the primary causative agent.

Purpose of the Study:

  • To understand the epidemiology, clinical findings, diagnosis, and treatment of infections caused by Exserohilum rostratum.
  • To analyze the impact of the outbreak on pharmaceutical compounding regulations.
  • To identify critical factors in public health response to such outbreaks.

Main Methods:

  • Epidemiologic surveillance and case investigations.
  • Basic science studies on Exserohilum rostratum.
  • Analysis of clinical data from affected patients.

Main Results:

  • Exserohilum rostratum identified as the predominant pathogen.
  • Studies provided guidance on diagnosis and treatment strategies.
  • The outbreak spurred legislation for increased regulation of pharmaceutical compounding.

Conclusions:

  • A strong clinician-public health relationship and rapid response were vital in preventing further cases.
  • Long-term prognosis and outcomes for affected patients require further investigation.
  • The outbreak underscored vulnerabilities in pharmaceutical compounding and regulatory oversight.

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