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Mycobacterium simiae Outbreak Associated With a Hospital Water Supply

  • Nicholas G. Conger (a1), Robert J. O'Connell (a1), Valerie L. Laurel (a1), Kenneth N. Olivier (a1), Edward A. Graviss (a2), Natalie Williams-Bouyer (a2), Yansheng Zhang (a3), Barbara A. Brown-Elliott (a3) and Richard J. Wallace (a3)...
Abstract
AbstractObjective:

Mycobacterium simiae is found primarily in the southwestern United States, Israel, and Cuba, with tap water as its suspected reservoir. Our institution saw an increase in M. simiae isolates in 2001. An investigation into possible contaminated water sources was undertaken.

Design:

Environmental cultures were performed from water taps in the microbiology laboratory, patient rooms, points in the flow of water to the hospital, and patients' homes. Patient and environmental M. simiae were compared by PFGE.

Setting:

Military treatment facility in San Antonio, Texas.

Patients:

All patients with cultures positive for M. simiae between January 2001 and April 2002. Medical records were reviewed.

Results:

M. simiae was recovered from water samples from the hospital, patients' home showers, and a well supplying the hospital. A single PFGE clone was predominant among water isolates (9 of 10) and available patient isolates (14 of 19). There was an association between exposure to hospital water and pulmonary samples positive for the clonal M. simiae strain (P = .0018). Only 3 of 22 culture-positive patients met criteria for M. simiae pulmonary disease. Of them, two had indistinguishable M. simiae strains from tap water to which they were routinely exposed.

Conclusions:

This represents an outbreak of M. simiae colonization with one nosocomial infection. It is only the second time that M. simiae has been recovered from hospital tap water and its first presentation in municipal water. This study raises issues about the need and feasibility of eliminating or avoiding exposure to M. simiae from tap water.

Copyright
Corresponding author
Wilford Hall Medical Center, Infectious Disease, 59 MDW, 2200 Bergquist Drive, Suite 1, Lackland AFB, TX 78236-5300
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2. A Lavy , Y Yoshpe-Purer . Isolation of Mycobacterium simiae from clinical specimens in Israel. Tubercle 1982;63:279285.

4. JG Weiszfeiler , V Karasseva , E Karczag . Mycobacterium simiae and related mycobacteria. Rev Infect Dis 1981;3:10401045.

7. F Portaels . Epidemiology of mycobacterial diseases. Clin Dermatol 1995;13:207222.

8. KH Schroder , J Kazda , K Muller , HJ Muller . Isolation of Mycobacterium simiae from the environment. Zentralblatt fur Bakteriologie 1992;277:561564.

9. B Vandercam , J Gala , B Vandeweghe , et al.Mycobacterium simiae disseminated infection in a patient with acquired immunodeficiency syndrome. Infection 1996;24:4951.

12. HM Al-Abdely , SG Revankar , JR Graybill . Disseminated Mycobacterium simiae infection in patients with AIDS. J Infect 2000;41:143147.

13. JL Koeck , T Debord , M Fabre , V Vincent , JD Cavallo , R Le Vagueresse . Disseminated Mycobacterium simiae infection in a patient with AIDS: clinical features and treatment. Clin Infect Dis 1996;23:832833.

14. D Huminer , S Dux , Z Samra , et al.Mycobacterium simiae infection in Israeli patients with AIDS. Clin Infect Dis 1993;17:508509.

15. RC Bell , JH Higuchi , WN Donovan , I Krasnow , WG Johanson Jr Mycobacterium simiae: clinical features and follow-up of twenty-four patients. Am Rev Respir Dis 1983;127:3538.

16. G Valero , J Peters , JH Jorgensen , JR Graybill . Clinical isolates of Mycobacterium simiae in San Antonio, Texas: an 11-yr review. Am J Respir Crit Care Med 1995;152:15551557.

17. DL Rynkiewicz , GD Cage , WR Butler , NM Ampel . Clinical and microbiological assessment of Mycobacterium simiae isolates from a single laboratory in southern Arizona. Clin Infect Dis 1998;26:625630.

18. HM El Sahly , E Septimus , H Soini , et al.Mycobacterium simiae pseudo-outbreak resulting from a contaminated hospital water supply in Houston, Texas. Clin Infect Dis 2002;35:802807.

20. SE Hoffner . Pulmonary infections caused by less frequently encountered slow-growing environmental mycobacteria. Eur J Clin Microbiol Infect Dis 1994;13:937941.

30. EJ Anaissie , SR Penzak , MC Dignani . The hospital water supply as a source of nosocomial infections: a plea for action. Arch Intern Med 2002;162:14831492.

31. CF von Reyn , JN Maslow , TW Barber , JO Falkinham 3rd RD Arbeit . Persistent colonization of potable water as a source of Mycobacterium avium infection in AIDS. Lancet 1994;343:11371141.

33. C Squier , VL Yu , JE Stout . Waterborne nosocomial infections. Cur Infectious Disease Report 2000;2:490496.

34. MJ Tobin-D'Angelo , MA Blass , C del Rio , JS Halvosa , HM Blumberg , CR Horsburgh Jr Hospital water as a source of Mycobacterium avium complex isolates in respiratory specimens. J Infect Dis 2004;189:98104.

36. DN Burns , RJ Wallace Jr ME Schultz , et al.Nosocomial outbreak of respiratory tract colonization with Mycobacterium fortuitum: demonstration of the usefulness of pulsed-field gel electrophoresis in an epidemiologic investigation. Am Rev Respir Dis 1991;144:11531159.

37. MD Iseman . Mycobacterium avium complex and the normal host: the other side of the coin. N Engl J Med 1989;321:896898.

38. N Singh , VL Yu . Potable water and Mycobacterium avium complex in HIV patients: is prevention possible? Lancet 1994;343:11101111.

39. TC Lee , JE Stout , VL Yu . Factors predisposing to Legionella pneumophila colonization in residential water systems. Arch Environ Health 1988;43:5962.

41. Z Liu , JE Stout , L Tedesco , et al.Controlled evaluation of copper-silver ionization in eradicating Legionella pneumophila from a hospital water distribution system. J Infect Dis 1994;169:919922.

42. Y-SE Lin , RD Vidic , JE Stout , CA McCartney , VL Yu . Inactivation of Mycobacterium avium by copper and silver ions. Water Res 1998;32:19972000.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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