Saturday, November 3, 2012

Meningitis Outbreak: Tests reveal fungi, but cause is mystery

9:48 PM, Nov 3, 2012

One is a common black mold that likes to feast on bread. Another is pigmented yeast that can live in the air, soil and water. A third is a fungus, usually found in soil and on plants, that thrives in warm and humid climates.
All seemingly different, yet they share one thing in common: They were in supposedly sterile medications prepared by the specialty pharmacy linked to a nationwide fungal meningitis outbreak that has sickened 404 and killed 29, including 12 in Tennessee.
So far, lab tests have found three types of fungus and 10 bacterial strains in unopened medicines that New England Compounding Center produced in its Framingham, Mass., facility. And more contaminants likely will be discovered as the impacts of the facility’s unsterile conditions become clearer, experts said.
“Those findings are not surprising, given how appalling the conditions were when those drugs were being made,” said Dr. Michael Carome of Public Citizen, a nonprofit advocacy group. “It would be surprising if they don’t find more contaminants.”
However, scientists may never be able to unravel exactly how the drugs became contaminated.

Three fungi confirmed

Federal health officials believe three NECC-produced lots of preservative-free methylprednisolone acetate (MPA), a corticosteroid that’s often injected to relieve pain, are responsible for the outbreak. All of the victims received shots in their backs or joints from those lots.
Those lots, as well as every NECC-made product on the market, have been recalled and now are being spot-tested for sterility.
The U.S. Centers for Disease Control and Prevention and the Federal Drug Administration say their labs have found three kinds of fungus in unopened MPA vials from two of those suspect lots:
• Exserohilum rostratum, which likes soils and plants in warm, damp conditions.
• Rhizopus stolonifer, a common black bread mold.
• Rhodotorula laryngis, a yeast that can be found just about anywhere in the environment.
Test results from the third lot have not been made public, but the CDC said the other results “strengthen the link between preservative-free MPA vials and the outbreak.”

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