Shelby Slagle, a 27 years old heart transplant patient died last June in the cardiothoracic intensive care unit at the University of Pittsburgh Medical Center (UPMC) from an opportunistic Rhizopus sp. Infection. In the 18 months preceding her death, two patients who had stayed in the same room as Slagle also died from similar infections, and more patients have recently become fatally infected by this fungus throughout the UPMC hospital system.
Slagle was born with a heart anomaly that created a hole between the ventricles in her heart. Despite a normal childhood, she developed increasing fatigue and abdominal edema during her early 20’s. in 2014, after a pacemaker failed to relieve her symptoms, doctors at UPMC put her on the transplant list to receive a replacement for her slowly failing heart. She received a new heart from an unknown female donor on May 4, 2015 and began to recover normally.
Unfortunately, her health suddenly declined two and a half weeks after the surgery when she was moved into a negative pressure room in the cardiothoracic intensive care unit. She developed an infected bedsore that resisted treatment. Doctors quickly diagnosed her with a Rhizopus infection and performed surgery to remove the infected tissue, but the procedure failed to improve Slagle’s prognosis. She progressively declined, requiring a breathing tube and suffering from hallucinations until finally dying on June 26, 2015.
After her death, the Centers for Disease Control and Prevention has been working with UPMC to address this troubling pattern of fungal infections. They have advised (and UPMC has agreed) to stop placing immunosuppressed patients like Slagle into negative pressure rooms until greater preventative measures can be developed.
Negative pressure rooms are designed to protect hospitals from the spread of infectious diseases. They draw outside air into the room, and prevent it from moving back into the hospital. Thus, if a patient with a dangerous infection is housed in the room, the rest of the hospital is safe because infected air inside the room cannot recirculate within the building. Recent consideration has proposed that despite this advantage, these rooms may be harmful to people with compromised immune systems or on immunosuppressant drugs (such as transplant recipients) because the continuous flow of air into the room may carry spores from dangerous fungi like Rhizopus. There is no way to be sure, but doctors presume that this is how Slagle and the other patients became infected.
In August 2016 UBMC settled lawsuits with the families of these unfortunate patients, including $1.35 million settlements each paid to Slagle’s husband and parents.