Division of Infectious Diseases, Department of Medicine, NYU Grossman School of Medicine.
Department of Infection Control, Bellevue Hospital Center, New York City Health and Hospitals.
Curr Opin Infect Dis. 2022 Aug 1;35(4):330-338. doi: 10.1097/QCO.0000000000000844. Epub 2022 Jul 5.
The purpose of this review is to summarize recent literature on nontuberculous mycobacteria in water of healthcare systems. Despite improvement in identification techniques and emergence of infection prevention and control programs, nontuberculous mycobacteria remain present in hospital water systems, causing outbreaks and pseudo-outbreaks in healthcare settings.
Waterborne outbreaks and pseudo-outbreaks of nontuberculous mycobacteria continue to affect hospitals. Improvements in methods of identification and investigation, including MALDI-TOF and whole genome sequencing with evaluation of single nucleotide polymorphisms, have been used successfully in outbreak and pseudo-outbreak investigations. Recent studies have shown control of outbreaks in immunocompromised patients through the use of sterile water for consumption, as well as control of pseudo-outbreaks by using sterile water for procedures. Construction activities have been implicated in outbreaks and pseudo-outbreaks of nontuberculous mycobacteria. Water management programs are now required by the Joint Commission, which will likely improve water risk mitigation.
Improvement in detection and identification of nontuberculous mycobacteria has led to increasing recognition of waterborne outbreaks and pseudo-outbreaks. Water management programs are of vital importance in infection prevention.
本综述旨在总结有关医疗系统水中非结核分枝杆菌的最新文献。尽管鉴定技术有所改进，感染预防和控制项目也已出现，但非结核分枝杆菌仍存在于医院的供水系统中，导致医疗机构中暴发和类暴发疫情。
水源性非结核分枝杆菌暴发和类暴发疫情仍在影响着医院。包括 MALDI-TOF 和全基因组测序以及单核苷酸多态性评估在内的鉴定和调查方法的改进，已成功应用于暴发和类暴发疫情的调查中。最近的研究表明，通过使用无菌水进行饮用，可控制免疫功能低下患者的暴发疫情，通过使用无菌水进行操作，可控制类暴发疫情。建筑活动与非结核分枝杆菌的暴发和类暴发疫情有关。联合委员会现在要求实施供水管理计划，这将很可能改善水源风险的缓解措施。
非结核分枝杆菌的检测和鉴定技术的改进，使得人们越来越多地认识到水源性暴发和类暴发疫情。供水管理计划对于感染预防至关重要。
