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抽脂术后发生龟分枝杆菌感染疫情。

An outbreak of Mycobacterium chelonae infection following liposuction.

作者信息

Meyers Hildy, Brown-Elliott Barbara A, Moore Douglas, Curry Jan, Truong Cecile, Zhang Yansheng, Wallace Jr Richard J

机构信息

County of Orange Health Care Agency/Public Health, Santa Ana, CA, 92706, USA.

出版信息

Clin Infect Dis. 2002 Jun 1;34(11):1500-7. doi: 10.1086/340399. Epub 2002 May 10.

Abstract

Among 82 patients who underwent liposuction performed by a single practitioner in a 6-month period, 34 (41%) developed cutaneous abscesses. An organism identified as Mycobacterium chelonae by polymerase chain reaction restriction-enzyme analysis was recovered from cultures of samples from 12 of those patients. DNA large restriction-fragment pattern analysis by pulsed-field gel electrophoresis demonstrated that a strain of M. chelonae recovered from biofilm in the piped-water system in one of the physician's offices differed by only 2 restriction fragments from the 12 patient isolates, which differed from each other by 0 or 1 restriction fragment. A detailed retrospective cohort study that included interviews with former employees and statistical analysis of risk factors indicated that inadequate sterilization and rinsing of surgical equipment with tap water were likely sources of mycobacterial contamination. This is the first reported outbreak of nosocomial infection due to M. chelonae in which a source has been identified and the first to occur in association with liposuction in patients in the United States.

摘要

在6个月内由一名医生进行抽脂手术的82名患者中,有34名(41%)出现了皮肤脓肿。通过聚合酶链反应限制性酶分析鉴定为龟分枝杆菌的一种微生物,从其中12名患者的样本培养物中分离出来。通过脉冲场凝胶电泳进行的DNA大限制性片段模式分析表明,从该医生一间办公室的管道水系统生物膜中分离出的一株龟分枝杆菌,与12名患者分离株相比,仅相差2个限制性片段,而这些患者分离株之间相差0或1个限制性片段。一项详细的回顾性队列研究,包括对前雇员的访谈和危险因素的统计分析,表明手术设备用自来水进行的消毒和冲洗不充分可能是分枝杆菌污染的来源。这是首次报告的因龟分枝杆菌引起的医院感染暴发,其中已确定了传染源,也是美国首例与抽脂手术相关的此类感染。

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