Prabaker Kavitha, Muthiah Chethra, Hayden Mary K, Weinstein Robert A, Cheerala Jyothirmai, Scorza Mary L, Segreti John, Lavin Mary A, Schmitt Barbara A, Welbel Sharon F, Beavis Kathleen G, Trenholme Gordon M
1University of Colorado,Aurora,CO,USA.
2Metro Infectious Disease Consultants,Chicago,IL,USA.
Infect Control Hosp Epidemiol. 2015 Feb;36(2):198-203. doi: 10.1017/ice.2014.28.
OBJECTIVE To identify the source of a pseudo-outbreak of Mycobacterium gordonae DESIGN Outbreak investigation. SETTING University Hospital in Chicago, Ilinois. PATIENTS Hospital patients with M. gordonae-positive clinical cultures. METHODS An increase in isolation of M. gordonae from clinical cultures was noted immediately following the opening of a newly constructed hospital in January 2012. We reviewed medical records of patients with M. gordonae-positive cultures collected between January and December 2012 and cultured potable water specimens in new and old hospitals quantitatively for mycobacteria. RESULTS Of 30 patients with M. gordonae-positive clinical cultures, 25 (83.3%) were housed in the new hospital; of 35 positive specimens (sputum, bronchoalveolar lavage, gastric aspirate), 32 (91.4%) had potential for water contamination. M. gordonae was more common in water collected from the new vs. the old hospital [147 of 157 (93.6%) vs. 91 of 113 (80.5%), P=.001]. Median concentration of M. gordonae was higher in the samples from the new vs. the old hospital (208 vs. 48 colony-forming units (CFU)/mL; P<.001). Prevalence and concentration of M. gordonae were lower in water samples from ice and water dispensers [13 of 28 (46.4%) and 0 CFU/mL] compared with water samples from patient rooms and common areas [225 of 242 (93%) and 146 CFU/mL, P<.001]. CONCLUSIONS M. gordonae was common in potable water. The pseudo-outbreak of M. gordonae was likely due to increased concentrations of M. gordonae in the potable water supply of the new hospital. A silver ion-impregnated 0.5-μm filter may have been responsible for lower concentrations of M. gordonae identified in ice/water dispenser samples. Hospitals should anticipate that construction activities may amplify the presence of waterborne nontuberculous mycobacterial contaminants.
目的 确定戈登分枝杆菌假暴发的来源 设计 暴发调查。 地点 伊利诺伊州芝加哥的大学医院。 患者 临床培养物中戈登分枝杆菌呈阳性的医院患者。 方法 2012年1月新建医院开业后，临床培养物中分离出的戈登分枝杆菌立即出现增加。我们回顾了2012年1月至12月期间收集的戈登分枝杆菌培养阳性患者的病历，并对新老医院的饮用水标本进行了分枝杆菌定量培养。 结果 在30例临床培养物中戈登分枝杆菌呈阳性的患者中，25例（83.3%）住在新医院；在35份阳性标本（痰液、支气管肺泡灌洗、胃液抽吸物）中，32份（91.4%）有被水污染的可能。新医院采集的水中戈登分枝杆菌比老医院更常见[157份中的147份（93.6%）对113份中的91份（80.5%），P = 0.001]。新医院样本中戈登分枝杆菌的中位数浓度高于老医院（208对48菌落形成单位（CFU）/毫升；P < 0.001）。与病房和公共区域的水样相比，制冰机和饮水机水样中戈登分枝杆菌的患病率和浓度较低[28份中的13份（46.4%）和0 CFU/毫升]对[242份中的225份（93%）和146 CFU/毫升，P < 0.001]。 结论 戈登分枝杆菌在饮用水中很常见。戈登分枝杆菌的假暴发可能是由于新医院饮用水供应中戈登分枝杆菌浓度增加所致。含银离子的0.5微米过滤器可能是制冰机/饮水机样本中戈登分枝杆菌浓度较低的原因。医院应预计到建设活动可能会增加水源性非结核分枝杆菌污染物的存在。
