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

Published online by Cambridge University Press:  18 December 2014

Kavitha Prabaker*
Affiliation:
University of Colorado, Aurora, CO, USA
Chethra Muthiah
Affiliation:
Metro Infectious Disease Consultants, Chicago, IL, USA
Mary K. Hayden
Affiliation:
Rush University Medical Center, Chicago, IL, USA
Robert A. Weinstein
Affiliation:
Rush University Medical Center, Chicago, IL, USA Cook County Health and Hospital Systems, Chicago, IL, USA
Jyothirmai Cheerala
Affiliation:
Rush University Medical Center, Chicago, IL, USA
Mary L. Scorza
Affiliation:
Rush University Medical Center, Chicago, IL, USA
John Segreti
Affiliation:
Rush University Medical Center, Chicago, IL, USA
Mary A. Lavin
Affiliation:
Saint Anthony Hospital, Chicago, IL, USA
Barbara A. Schmitt
Affiliation:
Rush University Medical Center, Chicago, IL, USA
Sharon F. Welbel
Affiliation:
Cook County Health and Hospital Systems, Chicago, IL, USA
Kathleen G. Beavis
Affiliation:
University of Chicago, Chicago, IL, USA
Gordon M. Trenholme
Affiliation:
Rush University Medical Center, Chicago, IL, USA
*
Address correspondence to Kavitha Prabaker, MD, 1635 Aurora Ct, Box B163, Aurora, CO 80045 ([email protected]).

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

Type
Original Articles
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

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

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