Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Nightingale Hospital, Belfast, Northern Ireland, UK.
Int J Mycobacteriol. 2021 Jul-Sep;10(3):301-306. doi: 10.4103/ijmy.ijmy_138_21.
To date, there have been no reports on the occurrence of nontuberculous mycobacterial (NTM) organisms (nor tuberculosis [TB]) on money, currency, banknotes, or coins, where these may act as fomites in the potential transmission of mycobacterial organisms around communities, especially in developing nations, where physical currency is still the popular mainstay of the economy, compared to electronic and digital forms of currency transaction. It was therefore the aim of this study to examine the survival of the Mycobacterium abscessus complex organisms on coins.
Coins from 17 countries were examined for the presence of M. abscessus complex organisms by broth enrichment in Middlebrook 7H9 for 2 months. Nickel-plated steel and copper-plated steel coins were artificially contaminated individually with M. abscessus complex (circa 10 [7 log] organisms/coin), including M. abscessus subsp. massiliense (n = 2), M. abscessus subsp. bolletti (n = 2), and M. abscessus subsp. abscessus (n = 1) and their surviving cells enumerated at weekly period up to 5-week postinoculation.
NTM organisms were not isolated from coins from the 17 currencies examined. In all three subspecies of M. abscessus, the copper-plated steel coins caused a more rapid decline in organism numbers, which were statistically very significant (P < 0.0001), compared to the paired survival on the nickel-plated steel coins, whereby organisms were none detectable after 3-week storage on the copper-plated coins. NTM organisms survived better on the nickel-plated coins, with a mean count across all subspecies of log 1.84 colony forming units per coin after 5 weeks of storage (range: 0.6-2.69 log cfu/coin). There was no statistically significant difference (P > 0.05; 5%) in the survival dynamics among the three subspecies with storage on either coin type.
Health-care professionals should be aware of the survival of M. abscessus complex organisms on coins for up to 12 weeks, which may be particular relevant in high-risk areas of health-care institutions where TB or NTM is prevalent and where there are opportunities for the transmission of such organisms through contaminated fomites, including coins, through opportunities including payment for treatments/medicines/dressings, coin-operated payment facilities, such as hospital car parking, self-service vending machines, hospital canteens, coffee shops and dining halls and hospital shops, whether static or mobile onward visits. To mitigate potential infection consequences of handling coins contaminated with M. abscessus complex organisms, other NTMs organisms and TB, the authors support re-establishing the principles of basic hygiene, including proper handwashing and the avoidance of handling money when working with food or dressing wounds and skin lesions, as well as when working with respiratory devices, including nebulizers.
迄今为止，尚无关于非结核分枝杆菌（NTM）生物体（也不包括结核病[TB]）在货币、钞票或硬币上出现的报告，而在社区中，这些可能成为分枝杆菌生物体潜在传播的媒介，尤其是在发展中国家，与电子和数字形式的货币交易相比，实物货币仍然是经济的主要支柱。因此，本研究旨在检查脓肿分枝杆菌复合体在硬币上的存活情况。
通过在 Middlebrook 7H9 肉汤中进行 2 个月的富集，检查来自 17 个国家的硬币是否存在脓肿分枝杆菌复合体生物体。单独用脓肿分枝杆菌复合体（约 10 [7 log]个生物体/硬币）人工污染镀镍钢和镀铜钢硬币，包括脓肿分枝杆菌亚种马萨利恩塞亚种（n=2）、脓肿分枝杆菌亚种 bolletti（n=2）和脓肿分枝杆菌亚种 abscessus（n=1），并在接种后每周计数其存活细胞，最多可达 5 周。
从检查的 17 种货币中均未分离出 NTM 生物体。在所有三种脓肿分枝杆菌亚种中，与配对的在镀镍钢硬币上的存活情况相比，铜镀钢硬币导致生物体数量的下降更快，差异具有统计学意义（P < 0.0001），在铜镀硬币上储存 3 周后，无法检测到生物体。NTM 生物体在镀镍钢硬币上的存活情况更好，在 5 周的储存后，所有亚种的平均菌落形成单位计数为每枚硬币 1.84 个（范围：0.6-2.69 log cfu/coin）。在任何一种硬币类型上，三种亚种的存活动力学之间没有统计学上的显著差异（P > 0.05；5%）。
医务人员应注意脓肿分枝杆菌复合体在硬币上的存活时间长达 12 周，这在结核病或 NTM 流行的医疗机构的高风险区域可能特别相关，并且存在通过受污染的媒介物（包括硬币）传播这些生物体的机会，包括通过支付治疗/药物/敷料、硬币操作的支付设施（如医院停车场、自助售货机、医院食堂、咖啡店和餐厅以及医院商店）进行支付，无论是静态的还是移动的后续访问。为了减轻处理被脓肿分枝杆菌复合体、其他 NTM 生物体和 TB 污染的硬币所带来的潜在感染后果，作者支持重新确立基本卫生原则，包括在处理食物或处理伤口和皮肤损伤以及在处理呼吸设备（包括雾化器）时，正确洗手和避免处理货币。
