Keratitis outbreak linked to environmental mould at New York eye clinic

The US Centers for Disease Control and Prevention (CDC) have published a report on three cases of fungal keratitis following laser eye surgery at a New York ophthalmology clinic.

The report highlighted that three patients developed Purpureocillium lilacinum infections after undergoing surgery at a single clinic. All three patients experienced vision loss, with one patient subsequently requiring corneal transplantation.

An investigation by the New York City Health Department found “multiple deficiencies” in the ophthalmology clinic’s infection prevention and control (IPC) practices.

These included incomplete instrument sterilisation logs, use of expired topical ocular medications, and opportunities for exposure to non-sterile water from cool-mist humidifiers in the procedure room. The CDC advises against the use of cool-mist humidifiers in health care facilities.

Laboratory testing identified P. lilacinum DNA in the tubing of a surgical device.

After the cases were reported in December 2024, surgeries were suspended, before resuming in January 2025.

“No further cases were identified after implementation of recommended IPC measures,” the CDC report highlighted.

The report authors highlighted that P. lilacinum infections are often associated with soft contact lens use, eye trauma, eye surgery, and immunosuppression.

“Because P. lilacinum is known to cause drug-resistant keratitis, and rates of detection are increasing, P. lilacinum should be considered as a potential cause of infection after eye surgery, even before definitive culture identification,” they noted.