Prolonged postprocedural outbreak of Mycobacterium massiliense infections associated with ultrasound transmission gel.
Clin Microbiol Infect
; 22(4): 382.e1-382.e11, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26794030
ABSTRACT
Postprocedural infections by Mycobacterium abscessus complex are increasing worldwide, and the source and route of transmission are infrequently identified. Here the extension of a previous clustering of paediatric patients with surgical site infections due to a single strain of the subspecies M. massiliense is reported. The investigation was conducted at a 2200-bed teaching hospital in Taiwan and included microbial surveillance of the environment (water, air, equipment and supplies) and a case-control study. We performed molecular identification and typing of the isolates by a trilocus sequencing scheme, confirmed by multilocus sequencing typing and pulsed-field gel electrophoresis. We investigated 40 patients who developed postprocedure soft tissue or bloodstream infections by M. massiliense (TPE101) during a 3-year period. Thirty-eight patients were identified at hospital A, and one newborn and her mother were identified at hospital B (185 km from hospital A). A case-control study identified the association of invasive procedures (adjusted odds ratio, 9.13) and ultrasonography (adjusted odds ratio, 2.97) (both p <0.05) with acquiring the outbreak strain. Isolates from the cases and unopened bottles of ultrasound transmission gel were all of strain ST48 and indistinguishable or closely related by pulsed-field gel electrophoresis. After replacement of contaminated gel, no new cases were detected during 18 months' follow-up. This investigation identified the use of contaminated gel as the common source causing an outbreak on a larger scale than had been recognized. Our findings halted production by the manufacturer and prompted revision of hospital guidelines.
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Base de dados:
MEDLINE
Assunto principal:
Infecção da Ferida Cirúrgica
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Contaminação de Medicamentos
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Surtos de Doenças
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Ultrassonografia
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Micobactérias não Tuberculosas
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Infecções por Mycobacterium não Tuberculosas
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Infant
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Male
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Middle aged
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Newborn
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article