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Outbreak of non-tuberculous mycobacteria skin or soft tissue infections associated with handling fish – New York City, 2013–2014

  • K. YACISIN (a1) (a2), J. L. HSIEH (a1), D. WEISS (a1), J. ACKELSBERG (a1), E. LEE (a1), L. JONES (a1), Y. L. LEUNG (a1), L. LI (a1), J. YUNG (a1), S. SLAVINSKI (a1), H. HANSON (a1), A. RIDPATH (a1) (a2), J. KORNBLUM (a1), Y. LIN (a1), S. ROBBE-AUSTERMAN (a3), J. RAKEMAN (a1), U. SIEMETZKI-KAPOOR (a1), T. STUBER (a3) and S. K. GREENE (a1)...

Summary

Mycobacterium marinum, a bacterium found in freshwater and saltwater, can infect persons with direct exposure to fish or aquariums. During December 2013, the New York City Department of Health and Mental Hygiene learned of four suspected or confirmed M. marinum skin or soft tissue infections (SSTIs) among persons who purchased whole fish from Chinese markets. Ninety-eight case-patients with non-tuberculous mycobacteria (NTM) SSTIs were identified with onset June 2013–March 2014. Of these, 77 (79%) were female. The median age was 62 years (range 30–91). Whole genome sequencing of clinical isolates revealed two main clusters and marked genetic diversity. Environmental samples from distributors yielded NTM though not M. marinum. We compared 56 case-patients with 185 control subjects who shopped in Chinese markets, frequency-matched by age group and sex. Risk factors for infection included skin injury to the finger or hand (odds ratio [OR]: 15·5; 95% confidence interval [CI]: 6·9–37·3), hand injury while preparing fish or seafood (OR 8·3; 95% CI 3·8–19·1), and purchasing tilapia (OR 3·6; 95% CI 1·1–13·9) or whiting (OR 2·7; 95% CI 1·1–6·6). A definitive environmental outbreak source was not identified.

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Copyright

Corresponding author

*Author for correspondence: K. Yacisin, 3311 Toledo Rd, Hyattsville, MD 20782, USA. (Email: kyacisin@cdc.gov)

References

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1. Toranzo, A, Magarinos, B, Romalde, JL. A review of the main bacterial fish diseases in mariculture systems. Aquaculture 2005; 246: 3761.
2. Swaim, LE, et al. Mycobacterium marinum infection of adult zebrafish causes caseating granulomatous tuberculosis and is moderated by adaptive immunity. Infection and Immunity 2006; 74(11): 61086117.
3. Swift, S, Cohen, H. Granulomas of the skin due to Mycobacterium balnei after abrasions from a fish tank. The New England Journal of Medicine 1962; 267: 12441246.
4. Decostere, A, Hermans, K, Haesebrouck, F. Piscine mycobacteriosis: a literature review covering the agent and the disease it causes in fish and humans. Veterinary Microbiology 2004; 99(3–4): 159166.
5. Falkinham, JO III. Environmental sources of nontuberculous mycobacteria. Clinics in Chest Medicine 2015; 36(1): 3541.
6. Jernigan, JA, Farr, BM. Incubation period and sources of exposure for cutaneous Mycobacterium marinum infection: case report and review of the literature. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 2000; 31(2): 439443.
7. Cheung, JP, et al. Mycobacterium marinum infection of the hand and wrist. Journal of Orthopaedic Surgery (Hong Kong) 2012; 20(2): 214218.
8. Kullavanijaya, P, Sirimachan, S, Bhuddhavudhikrai, P. Mycobacterium marinum cutaneous infections acquired from occupations and hobbies. International Journal of Dermatology 1993; 32(7): 504507.
9. Feng, Y, et al. Outbreak of a cutaneous Mycobacterium marinum infection in Jiangsu Haian, China. Diagnostic Microbiology and Infectious Disease 2011; 71(3): 267272.
10. Lillis, JV, et al. Sequelae of World War II: an outbreak of chronic cutaneous nontuberculous mycobacterial infection among Satowanese islanders. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 2009; 48(11): 15411546.
11. Gluckman, SJ. Mycobacterium marinum . Clinics in Dermatology 1995; 13(3): 273276.
12. Sia, TY, et al. Clinical and pathological evaluation of Mycobacterium marinum group skin infections associated with fish markets in New York City. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America 2016; 62(5): 590595.
13. New York City Health Code. Article 11, Reportable Diseases and Conditions (http://www1.nyc.gov/assets/doh/downloads/pdf/about/healthcode/health-code-article11.pdf). Accessed 2 May 2017.
14. New York City Department of Health and Mental Hygiene. 2014 Alert #6. Outbreak of Mycobacterium Infections after Preparing Live or Raw Fish or Seafood.
15. Ostland, VE, et al. Biochemical, molecular, and virulence characteristics of select Mycobacterium marinum isolates in hybrid striped bass Morone chrysops × M. saxatilis and zebrafish Danio rerio . Diseases of Aquatic Organisms 2008; 79(2): 107118.
16. Gardner, SN, Slezak, T, Hall, BG. kSNP3·0: SNP detection and phylogenetic analysis of genomes without genome alignment or reference genome. Bioinformatics 2015; 31(17): 28772878.
17. Simpson, JT, et al. ABySS: a parallel assembler for short read sequence data. Genome Research 2009; 19(6): 11171123.
18. Tatusova, T, et al. RefSeq microbial genomes database: new representation and annotation strategy. Nucleic Acids Research 2015; 43(7): 3872.
19. PASS 13 Power Analysis and Sample Size Software (2014). Kaysville, Utah, USA: NCSS, LLC. ncss.com/software/pass
20. Agresti, A. Exact inference for categorical data: recent advances and continuing controversies. Statistics in Medicine 2001; 20(17–18): 27092722.
21. Lopez, FK, Miley, M, Taiwo, B. Mycobacterium arupense as an emerging cause of tenosynovitis. Emerging Infectious Diseases 2016; 22(3): 559561.
22. Shimizu, T, et al. Successful treatment using clarithromycin for a cutaneous lesion caused by Mycobacterium szulgai . British Journal of Dermatology 2000; 142(4): 838840.
23. U.S. Centers for Disease Control and Prevention. Invasive infection with Streptococcus iniae–Ontario, 1995–1996. MMWR Morbidity and Mortality Weekly Report 1996; 45(30): 650653.

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