Pulse Brain · Growing Health Evidence Index
Tier 3 — Observational / field trialPeer-reviewed

Two-Phase Hospital-Associated Outbreak of <i>Mycobacterium abscessus</i>: Investigation and Mitigation

Arthur W. Baker, Sarah S. Lewis, Barbara D. Alexander, Luke F. Chen, Richard J. Wallace, Barbara A. Brown‐Elliott, Pamela J. Isaacs, Lisa C. Pickett, Chetan B. Patel, Peter K. Smith, John M. Reynolds, Jill Engel, Cameron R. Wolfe, Carmelo A. Milano, Jacob N. Schroder, Robert D. Davis, Matthew G. Hartwig, Jason E. Stout, Nancy Strittholt, Eileen K Maziarz, Jennifer Horan Saullo, Kevin C. Hazen, Richard Walczak, Ravikiran Vasireddy, Sruthi Vasireddy, Celeste McKnight, Deverick J. Anderson, Daniel J. Sexton

Clinical Infectious Diseases · 2017

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Summary

This epidemiological investigation tracked a biphasic hospital outbreak of Mycobacterium abscessus occurring between January 2013 and June 2015 at a tertiary care centre. The outbreak was linked to contamination of hospital tap water and affected distinct patient populations in two phases: predominantly lung transplant recipients in phase 1 and cardiac surgery patients in phase 2. Successful mitigation was achieved through water engineering interventions, implementation of tap water avoidance protocols for high-risk patients, and introduction of sterile water for cardiopulmonary bypass equipment.

Regional applicability

The findings are relevant to UK hospital infection control and water safety practices, particularly for tertiary care facilities managing immunocompromised patients. UK healthcare facilities with endemic nontuberculous mycobacteria should consider analogous water system audits and engineering controls to reduce infection risk in vulnerable populations.

Key measures

Incidence rate ratio (4.6, 95% CI 2.3–8.8); case counts by patient population; molecular fingerprinting results; incidence rates per 10,000 patient-days

Outcomes reported

The study documented a two-phase hospital outbreak of M. abscessus with incidence increasing 4.6-fold during phase 1 (August 2013–May 2014) compared to baseline, predominantly affecting lung transplant recipients, followed by a second phase affecting cardiac surgery patients. Molecular fingerprinting identified two clonal strains linked to hospital tap water sources, and targeted water engineering interventions and disinfection protocols successfully mitigated both outbreak phases.

Theme
General food systems / other
Subject
Pesticides, contaminants & food safety
Study type
Research
Study design
Epidemiological outbreak investigation with field and laboratory components
Source type
Peer-reviewed study
Status
Published
Geography
United States
System type
Human clinical
DOI
10.1093/cid/ciw877
Catalogue ID
BFmoef2oy5-zuxsuk

Topic tags

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