A Cluster of Central Line–Associated Bloodstream Infections Due to Rapidly Growing Nontuberculous Mycobacteria in Patients with Hematologic Disorders at a Japanese Tertiary Care Center: An Outbreak Investigation and Review of the Literature. (5th January 2015)

• Record Type: Journal Article
• Authors: Tagashira, Yasuaki; Kozai, Yasuji; Yamasa, Hitomi; Sakurada, Masako; Kashiyama, Tetsuya; Honda, Hitoshi
• Is Part Of: Infection control and hospital epidemiology. Volume 36:Number 1(2015)
• Page Start: 76
• Page End: 80
• Publication Date: 2015-01-05
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2014.14
• Languages: English
• ISSNs: 0899-823X

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="abs1" sec-type="general"> <title>BACKGROUND</title> <p>Rapidly growing nontuberculous mycobacteria (RGM) are considered rare pathogens, causing central line–associated bloodstream infection. We identified an outbreak of central line–associated bloodstream infection due to RGM at a hematology-oncology ward during a 5-month period.</p> </sec> <sec id="abs2" sec-type="general"> <title>DESIGN</title> <p>Outbreak investigation and literature review.</p> </sec> <sec id="abs3" sec-type="general"> <title>SETTING</title> <p>A Japanese tertiary care center.</p> </sec> <sec id="abs4" sec-type="general"> <title>PATIENTS</title> <p>Adults who were hospitalized at the hematology-oncology ward from October 15, 2011, through February 17, 2012.</p> </sec> <sec id="abs5" sec-type="results"> <title>RESULTS</title> <p>A total of 5 patients with a bloodstream infection due to RGM (4 cases of <italic>Mycobacterium mucogenicum</italic> and 1 case of <italic>Mycobacterium canariasense</italic> infection) were identified; of these, 3 patients had acute myeloid leukemia, 1 had acute lymphocytic leukemia, and 1 had aplastic anemia. Four of the 5 patients received cord blood transplantation prior to developing the bloodstream infection. All central venous catheters in patients with a bloodstream infection were removed. These patients promptly defervesced after catheter removal and their care was successfully managed without antimicrobial therapy. Surveillance cultures from the environment and water detected <italic>M. mucogenicum</italic> and <italic>M. canariasense</italic> in the water supply of the hematology-oncology ward. The isolates from the bloodstream infection and water sources were identical on the basis of 16S-rRNA gene sequencing.</p> </sec> <sec id="abs6" sec-type="conclusions"> <title>CONCLUSIONS</title> <p>The source of RGM in the outbreak of bloodstream infections likely was the ward tap water supply. Awareness of catheter-related bloodstream infections due to nontuberculous mycobacteria should be emphasized, especially where immunocompromised patients are at risk. Also, using antimicrobials after catheter removal to treat central line–associated bloodstream infection due to RGM may not be necessary.</p> <p>Infect Control Hosp Epidemiol 2015;36(1): 76–80</p> </sec> </abstract>