Lai K K, Brown B A, Westerling J A, Fontecchio S A, Zhang Y, Wallace R J
Department of Medicine, University of Massachusetts Medical School, USA.
Clin Infect Dis. 1998 Jul;27(1):169-75. doi: 10.1086/514635.
Beginning in 1993, an increase in clinical isolates of Mycobacterium abscessus was observed in a single hospital microbiology laboratory. This involved a cluster of four patients in June 1993 and five patients and a quality-control culture of distilled water in May 1994. Twenty-three M. abscessus isolates recovered between 1991 and 1996 were compared by random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). Sixteen of 21 clinical isolates recovered over a 6-year period and the distilled water isolate had identical RAPD-PCR patterns consistent with a single strain or clone. Only six of 15 patients had findings suggestive of clinical disease. Since the use of in-house-prepared distilled water was discontinued, no further laboratory contamination of clinical specimens has been observed. Molecular typing was the key to defining distilled water as the source of this pseudo-outbreak. Recognition of such outbreaks is important for prevention of unnecessary therapeutic and diagnostic interventions.
从1993年开始，在一家医院的微生物实验室中观察到脓肿分枝杆菌临床分离株数量增加。这包括1993年6月的一组4名患者，以及1994年5月的5名患者和一份蒸馏水的质量控制培养物。通过随机扩增多态性DNA聚合酶链反应（RAPD-PCR）对1991年至1996年间分离出的23株脓肿分枝杆菌进行了比较。在6年期间分离出的21株临床分离株中的16株以及蒸馏水分离株具有相同的RAPD-PCR模式，与单一菌株或克隆一致。15名患者中只有6名有提示临床疾病的发现。自从停止使用内部制备的蒸馏水后，未再观察到临床标本受到实验室污染。分子分型是确定蒸馏水为此次假暴发源头的关键。认识到此类暴发对于预防不必要的治疗和诊断干预很重要。
