Stine T M, Harris A A, Levin S, Rivera N, Kaplan R L
JAMA. 1987 Aug 14;258(6):809-11.
We describe a pseudoepidemic due to atypical mycobacteria contaminating the water used by a pathology laboratory and bronchoscopy suite on two floors of the same hospital building. Inspection of laboratory procedures revealed that contamination occurred during specimen processing in pathology and while obtaining the bronchoscopic specimens. Mycobacterium gordonae, Mycobacterium avium complex, and Mycobacterium scrofulaceum were identified. During an eight-month period, a total of 22 (31%) of 70 patients with positive acid-fast smears had either an illness inconsistent with tuberculosis or a known alternate diagnosis. Control was easily obtained by insertion of a 0.2-micron polymer filter into the outflow tubing of our pathology tap water-deionizing unit and the tap water source in the bronchoscopy suite. The pseudoepidemic led to additional diagnostic-therapeutic intervention, but no patient experienced delay in appropriate diagnosis. Pseudoepidemics due to atypical mycobacteria will likely be of increased importance in institutions providing care to patients with acquired immunodeficiency syndrome.
我们描述了一起假流行事件，该事件是由非典型分枝杆菌污染了同一医院大楼两层楼的病理实验室和支气管镜检查室所使用的水引起的。对实验室操作的检查发现，污染发生在病理科的标本处理过程中以及获取支气管镜标本时。鉴定出了戈登分枝杆菌、鸟分枝杆菌复合群和瘰疬分枝杆菌。在八个月的时间里，70例抗酸涂片阳性的患者中共有22例（31%）患有与结核病不符的疾病或已知的其他诊断。通过在我们病理科自来水去离子装置的流出管道以及支气管镜检查室的自来水水源中插入一个0.2微米的聚合物过滤器，很容易就实现了控制。这次假流行导致了额外的诊断治疗干预，但没有患者在适当诊断方面出现延误。在为获得性免疫缺陷综合征患者提供护理的机构中，由非典型分枝杆菌引起的假流行可能会变得更加重要。
