engleski

Nosocomial pseudo-outbreak of Mycobacterium gordonae associated with hospital’s water supplies contamination: a case series of 135 patients.

Nontuberculous mycobacteria (NTM) are opportunistic pathogens found in natural and human-engineered waters, including drinking water distribution systems. In 2009, a relative increase in the isolation of M. gordonae from pulmonary samples originated from General Hospital Zabok was noted by the National Mycobacteria Reference Laboratory, Zagreb. Retrospective epidemiological survey was conducted to asses possible contamination of patient samples with NTM. Total of 150 individual cases with pulmonary NTM isolates were identified in the period 2007-2012, and M. gordonae was the most frequently isolated species (n=135 ; 90%). Epidemiological service performed inspection and confirmed a contamination of cold tap water with M. gordonae. None of the 150 cases met the ATS/IDSA criteria for pulmonary NTM disease, and concomitant M. tuberculosis infection was confirmed in only 6 (4%) patients. Still, due to low awareness of NTM infections, in a significant proportion of patients (n=64 ; 42.6%), tuberculosis was diagnosed and anti- tuberculosis treatment was initiated. In addition to considerable costs due to patient isolation and treatment, unnecessary physical exams, radiological and laboratory testing were performed on patients’ contacts. Our work points out the importance of faster NTM identification in patient samples as well as the continuing education of hospital personnel.

M. gordonae; nosocomial pseudo-outbreak; NTM

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