Epidemic Intelligence Service, and.
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Clin Infect Dis. 2017 Oct 1;65(7):1152-1158. doi: 10.1093/cid/cix507.
Mycoplasma hominis is a commensal genitourinary tract organism that can cause infections outside the genitourinary tract. We investigated a cluster of M. hominis surgical site infections in patients who underwent spine surgery, all associated with amniotic tissue linked to a common donor.
Laboratory tests of tissue product from the donor, including culture, quantitative real-time polymerase chain reaction (qPCR), and whole-genome sequencing were performed. Use of this amniotic tissue product was reviewed. A multistate investigation to identify additional cases and locate any unused products was conducted.
Twenty-seven tissue product vials from a donor were distributed to facilities in 7 states; at least 20 vials from this donor were used in 14 patients. Of these, 4 of 14 (29%) developed surgical site infections, including 2 M. hominis infections. Mycoplasma hominis was detected by culture and qPCR in 2 unused vials from the donor. Sequencing indicated >99% similarity between patient and unopened vial isolates. For 5 of 27 (19%) vials, the final disposition could not be confirmed.
Mycoplasma hominis was transmitted through amniotic tissue from a single donor to 2 recipients. Current routine donor screening and product testing does not detect all potential pathogens. Clinicians should be aware that M. hominis can cause surgical site infections, and may not be detected by routine clinical cultures. The lack of a standardized system to track tissue products in healthcare facilities limits the ability of public health agencies to respond to outbreaks and investigate other adverse events associated with these products.
人型支原体是一种共生的泌尿生殖道微生物，可引起泌尿生殖道以外的感染。我们调查了一组与来自同一供体的羊膜组织相关的人型支原体手术部位感染患者，这些患者均接受过脊柱手术。
对供体组织产品进行实验室检测，包括培养、定量实时聚合酶链反应（qPCR）和全基因组测序。回顾了该羊膜组织产品的使用情况。开展了一项多州调查，以确定其他病例并定位任何未使用的产品。
从一名供体中分发了 27 个组织产品小瓶到 7 个州的医疗机构；至少有 20 个小瓶来自该供体，用于 14 名患者。其中，14 名患者中的 4 名（29%）发生了手术部位感染，包括 2 例人型支原体感染。在供体的 2 个未使用小瓶中通过培养和 qPCR 检测到了人型支原体。测序表明，患者和未开封小瓶分离株之间的相似度>99%。对于 27 个小瓶中的 5 个（19%），最终处置情况无法确认。
人型支原体通过来自单一供体的羊膜组织传播给了 2 名受者。目前的常规供体筛查和产品检测无法检测到所有潜在病原体。临床医生应意识到人型支原体可引起手术部位感染，并且可能不会被常规临床培养检测到。医疗机构中缺乏标准化的系统来跟踪组织产品，限制了公共卫生机构对疫情做出反应和调查与这些产品相关的其他不良事件的能力。
