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Pseudo-outbreak of Mycobacterium gordonae Following the Opening of a Newly Constructed Hospital at a Chicago Medical Center

  • Kavitha Prabaker (a1), Chethra Muthiah (a2), Mary K. Hayden (a3), Robert A. Weinstein (a3) (a4), Jyothirmai Cheerala (a3), Mary L. Scorza (a3), John Segreti (a3), Mary A. Lavin (a5), Barbara A. Schmitt (a3), Sharon F. Welbel (a4), Kathleen G. Beavis (a6) and Gordon M. Trenholme (a3)...

Abstract

OBJECTIVE

To identify the source of a pseudo-outbreak of Mycobacterium gordonae

DESIGN

Outbreak investigation.

SETTING

University Hospital in Chicago, Ilinois.

PATIENTS

Hospital patients with M. gordonae-positive clinical cultures.

METHODS

An increase in isolation of M. gordonae from clinical cultures was noted immediately following the opening of a newly constructed hospital in January 2012. We reviewed medical records of patients with M. gordonae-positive cultures collected between January and December 2012 and cultured potable water specimens in new and old hospitals quantitatively for mycobacteria.

RESULTS

Of 30 patients with M. gordonae-positive clinical cultures, 25 (83.3%) were housed in the new hospital; of 35 positive specimens (sputum, bronchoalveolar lavage, gastric aspirate), 32 (91.4%) had potential for water contamination. M. gordonae was more common in water collected from the new vs. the old hospital [147 of 157 (93.6%) vs. 91 of 113 (80.5%), P=.001]. Median concentration of M. gordonae was higher in the samples from the new vs. the old hospital (208 vs. 48 colony-forming units (CFU)/mL; P<.001). Prevalence and concentration of M. gordonae were lower in water samples from ice and water dispensers [13 of 28 (46.4%) and 0 CFU/mL] compared with water samples from patient rooms and common areas [225 of 242 (93%) and 146 CFU/mL, P<.001].

CONCLUSIONS

M. gordonae was common in potable water. The pseudo-outbreak of M. gordonae was likely due to increased concentrations of M. gordonae in the potable water supply of the new hospital. A silver ion-impregnated 0.5-μm filter may have been responsible for lower concentrations of M. gordonae identified in ice/water dispenser samples. Hospitals should anticipate that construction activities may amplify the presence of waterborne nontuberculous mycobacterial contaminants.

Infect Control Hosp Epidemiol 2014;00(0): 1–6

Copyright

Corresponding author

Address correspondence to Kavitha Prabaker, MD, 1635 Aurora Ct, Box B163, Aurora, CO 80045 (kavitha.prabaker@ucdenver.edu).

Footnotes

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These data were presented in part at ID Week 2013, San Francisco, CA, October 2–6, 2013.

Footnotes

References

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1. Falkinham, JO 3rd, Norton, CD, LeChevallier, MW. Factors influencing numbers of Mycobacterium avium, Mycobacterium intracellulare, and other mycobacteria in drinking water distribution systems. Appl Envir Microbiol 2001;67:12251231.
2. Mullis, SN, Falkinham, JO 3rd. Adherence and biofilm formation of Mycobacterium avium, Mycobacterium intracellulare and Mycobacterium abscessus to household plumbing materials. J Appl Microbiol 2013;115:908914.
3. Williams, MM, Armbruster, CR, Arduino, MJ. Plumbing of hospital premises is a reservoir for opportunistically pathogenic microorganisms: a review. Biofouling 2013;29:147162.
4. Arnow, PM, Bakir, M, Thompson, K, Bova, JL. Endemic contamination of clinical specimens by Mycobacterium gordonae . Clin Infect Dis 2000;31:472476.
5. Lalande, V, Barbut, F, Varnerot, A, et al. Pseudo-outbreak of Mycobacterium gordonae associated with water from refrigerated fountains. J Hosp Infect 2001;48:7679.
6. Panwalker, AP, Fuhse, E. Nosocomial Mycobacterium gordonae pseudoinfection from contaminated ice machines. Infect Control 1986;7:6770.
7. Stine, TM, Harris, AA, Levin, S, Rivera, N, Kaplan, RL. A pseudoepidemic due to atypical mycobacteria in a hospital water supply. JAMA 1987;258:809811.
8. Tokars, JI, McNeil, MM, Tablan, OC, et al. Mycobacterium gordonae pseudoinfection associated with a contaminated antimicrobial solution. J Clin Microbiol 1990;28:27652769.
9. Fujita, J, Nanki, N, Negayama, K, Tsutsui, S, Taminato, T, Ishida, T. Nosocomial contamination by Mycobacterium gordonae in hospital water supply and super-oxidized water. J Hosp Infect 2002;51:6568.
10. Gubler, JG, Salfinger, M, von Graevenitz, A. Pseudoepidemic of nontuberculous mycobacteria due to a contaminated bronchoscope cleaning machine. Report of an outbreak and review of the literature. Chest 1992;101:12451249.
11. Saukkonen, JJ, Cohn, DL, Jasmer, RM, et al. An official ATS statement: hepatotoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006;174:935952.
12. Griffith, DE, Aksamit, T, Brown-Elliott, BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175:367416.
13. Doebbeling, BN, Wenzel, RP. The epidemiology of Legionella pneumophila infections. Semin Respir Infect 1987;2:206221.
14. Krøjgaard, LH, Krogfelt, KA, Albrechtsen, HJ, Uldum, SA. Cluster of Legionnaires disease in a newly built block of flats, Denmark, December 2008 – January 2009. Euro Surveill 2011;16:19759.
15. Shih, HY, Lin, YE. Efficacy of copper-silver ionization in controlling biofilm- and plankton-associated waterborne pathogens. Appl Environ Microbiol 2010;76:20322035.
16. Gebo, KA, Srinivasan, A, Perl, TM, Ross, T, Groth, A, Merz, WG. Pseudo-outbreak of Mycobacterium fortuitum on a human immunodeficiency virus ward: transient respiratory tract colonization from a contaminated ice machine. Clin Infect Dis 2002;35:3238.
17. Williams, MM, Chen, TH, Keane, T, et al. Point-of-use membrane filtration and hyperchlorination to prevent patient exposure to rapidly growing mycobacteria in the potable water supply of a skilled nursing facility. Infect Control Hosp Epidemiol 2011;32:837844.

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