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An Outbreak of Bacteremias Associated With Mycobacterium mucogenicum in a Hospital Water Supply

Published online by Cambridge University Press:  02 January 2015

Susan Kline ,
Sarah Cameron ,
Andrew Streifel ,
Mitchell A. Yakrus ,
Frank Kairis ,
Keith Peacock ,
John Besser  and
Robert C. Cooksey
Susan Kline*
Affiliation:
Infection Control Department, Fairview-University Medical Center, Minneapolis, Minnesota Department of Medicine, Infectious Diseases Division, University of Minnesota, Minneapolis, Minnesota
Sarah Cameron
Affiliation:
Infection Control Department, Fairview-University Medical Center, Minneapolis, Minnesota
Andrew Streifel
Affiliation:
Infection Control Department, Fairview-University Medical Center, Minneapolis, Minnesota Department of Environmental Health, University of Minnesota, Minneapolis, Minnesota
Mitchell A. Yakrus
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
Frank Kairis
Affiliation:
Mycobacteriology Laboratory, Minnesota Department of Health, Minneapolis, Minnesota
Keith Peacock
Affiliation:
Water Bacteriology Laboratory, Minnesota Department of Health, Minneapolis, Minnesota
John Besser
Affiliation:
Microbiology Laboratory, Minnesota Department of Health, Minneapolis, Minnesota
Robert C. Cooksey
Affiliation:
Centers for Disease Control and Prevention, Atlanta, Georgia
*
Mayo Mail Code #250, 420 Delaware Street South East, Minneapolis, MN 55455
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Abstract

Objective:

To investigate and determine the cause of an outbreak of Mycobacterium mucogenicum bacteremias in bone marrow transplant (BMT) and oncology patients.

Design:

Case–control study and culturing of hospital water sources. Isolates were typed using molecular methods.

Setting:

University-affiliated, tertiary-care medical center.

Patients:

Case-patients were adult and pediatric BMT patients or hematopoietic stem cell transplant (BMT) (n = 5) and oncology (n = 1) patients who were diagnosed as having M. mucogenicum bacteremia during the study period of August through November 1998. Two control-patients were selected for each case-patient matched by age, time of hospitalization, inpatient unit, and type of patient (BMT or oncology).

Results:

There were no significant differences between case-patients and control-patients regarding intravenous products received or procedures performed, frequency of bathing, neutropenia, or steroid use. Nontuberculous mycobacteria were isolated from several water sources at the medical center including tap water from sinks and showerheads, the hospital hot water source, and the city water supply to the hospital. Analysis by multilocus enzyme electrophoresis and randomly amplified polymorphic DNA showed a match between one patient's blood isolate and an isolate from shower water from that patient's prior hospital room.

Conclusions:

The cause of the outbreak seemed to be water contamination of central venous catheters (CVCs) during bathing. A recommendation in early 2001 that CVCs be protected from water during bathing was followed by no M. mucogenicum bacteremias during the second half of 2001, only one in 2002, and none at all during 2003.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 12 , December 2004 , pp. 1042 - 1049
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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