Bolan G, Reingold A L, Carson L A, Silcox V A, Woodley C L, Hayes P S, Hightower A W, McFarland L, Brown J W, Petersen N J
J Infect Dis. 1985 Nov;152(5):1013-9. doi: 10.1093/infdis/152.5.1013.
Between April and November 1982, 27 of 140 patients in a hemodialysis center in Louisiana were infected with rapidly growing mycobacteria; 14 had bacteremia alone, 3 had soft-tissue infections, 1 had an access-graft infection, and 9 had widely disseminated disease. Of 26 identified isolates, 25 were Mycobacterium chelonei ssp. abscessus, and one was an M. chelonei-like organism. One factor common to all patients was exposure to processed hemodialyzers (artificial kidneys). Environmental sampling of the water-treatment system showed widespread contamination with nontuberculous mycobacteria, which were also recovered from the patient's side (blood compartment) of five of 31 hemodialyzers that had been processed and were ready for use. The formaldehyde concentration was less than 2% in two of three such contaminated dialyzers tested. We hypothesize that patients became infected when their blood circulated through processed dialyzers that contained viable rapidly growing mycobacteria. This outbreak demonstrates that hemodialysis patients may be at risk for developing infections with rapidly growing mycobacteria and that such infections may go unrecognized when routine culture methods are used. It also emphasizes the importance of using effective procedures to disinfect dialyzers in hemodialysis centers.
1982年4月至11月期间，路易斯安那州一家血液透析中心的140名患者中有27人感染了快速生长的分枝杆菌；14人仅患有菌血症，3人患有软组织感染，1人患有动静脉内瘘感染，9人患有广泛播散性疾病。在26株鉴定出的分离株中，25株为脓肿分枝杆菌龟分枝杆菌亚种，1株为类龟分枝杆菌。所有患者的一个共同因素是接触过经过处理的血液透析器（人工肾）。对水处理系统进行的环境采样显示，存在广泛的非结核分枝杆菌污染，在31个已处理并准备使用的血液透析器中，有5个的患者侧（血液腔）也检测到了这种细菌。在检测的3个此类受污染透析器中，有2个的甲醛浓度低于2%。我们推测，患者在其血液流经含有存活的快速生长分枝杆菌的经过处理的透析器时受到了感染。此次疫情表明，血液透析患者可能有感染快速生长分枝杆菌的风险，并且当使用常规培养方法时，此类感染可能未被识别。它还强调了在血液透析中心使用有效程序对透析器进行消毒的重要性。
