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Candida Osteomyelitis and Diskitis after Spinal Surgery: An Outbreak That Implicates Artificial Nail Use

Michael F. Parry, Brenda Grant, Marie Yukna, Debra Adler-Klein, Gavin X. McLeod, Rudolph Taddonio and Cory Rosenstein
Clinical Infectious Diseases
Vol. 32, No. 3 (Feb. 1, 2001), pp. 352-357
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4482483
Page Count: 6
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Candida Osteomyelitis and Diskitis after Spinal Surgery: An Outbreak That Implicates Artificial Nail Use
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Abstract

Postoperative wound infection after Iaminectomy is uncommon. In February 1997, 3 patients were confirmed to have postlaminectomy deep wound infections due to Candida albicans. No similar case had been seen during the previous 10 years. The infections were indolent, with a mean time from initial operation to diagnosis of 54 days (range, 26-83 days). All patients were successfully treated. Pulsed-field gel electrophoresis revealed the Candida isolates to be identical. A case-controlled study and medical record review revealed that a single operating room technician scrubbed on all 3 infected case patients but on only 32% of the uninfected controls. The technician had worn artificial nails for a 3-month period that included the dates of laminectomy site infections, and C. albicans was isolated from her throat. She was treated with fluconazole and removed from duty. No subsequent cases have occurred during the ensuing 3 years. Artificial nails are known to promote subungual growth of gram-negative bacilli and yeast. This may be clinically relevant, and hospitals should enforce policies to prevent operating room personnel from wearing artificial nails.

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