Pseudo-outbreak of Mycobacterium paragordonae in a hospital: possible role of the aerator/rectifier connected to the faucet of the water supply system
Pseudo-outbreak of Mycobacterium paragordonae in a hospital: possible role of the aerator/rectifier connected to the faucet of the water supply system
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DOI：
10.1016/j.jhin.2019.11.014
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发表时间：
2020-04-01
影响因子：
6.9
通讯作者：
Okayama, A.
中科院分区：
文献类型：
--
作者：
Takajo, I;Iwao, C.;Okayama, A.
背景：以前曾报道过与医院供水系统有关的非结核分枝杆菌（NTM）的假暴发。我们发现，2014年日本某医院重建改造后，临床样本中NTM的分离频率有所增加。目的：分析NTM与医院供水系统的关系及预防措施的效果。方法：对医院病房供水环境样品进行NTM检测。在获得阳性结果后，采用聚合酶链反应（PCR）进一步分析细菌。结果：NTM的PCR结果显示，大多数样品的副根支杆菌检测呈阳性。由于所分析的患者均未因这些细菌而发生任何疾病，因此该事件被认为是一次伪疫情。对供水系统的调查显示，在医院翻修期间从最近安装的曝气机/整流机所取得的样本对这些细菌呈阳性反应。因此，介绍了拆除曝气/整流器和防止患者在医院饮用自来水的措施。此后，该院ntm阳性样本出现频率显著下降。结论：本研究是为数不多的揭示医院可能发生副paragordonae假疫情的报道之一，因此提出了医院是否应该使用曝气/整流器的问题，因为它们的网状结构可能促进NTM在供水中的增殖。再次强调监测来自环境的细菌的重要性，特别是在医院重建/翻新后。(C) 2019作者。由Elsevier Ltd代表The Healthcare Infection Society出版。
Background: Pseudo-outbreaks of non-tuberculous mycobacteria (NTM) in association with the water supply system in hospitals have been previously reported. We found that the frequency of NTM isolation in clinical samples increased after the reconstruction and renovation of a hospital in Japan in 2014.Aim: To analyse NTM, their possible relationship with the hospital water supply system, and outcomes of preventive measures.Methods: Environmental samples obtained from the water supply in hospital wards were tested for NTM. On obtaining positive results, the bacteria were further analysed using polymerase chain reaction (PCR).Findings: The PCR products of NTM showed that most samples tested positive for Myco-bacterium paragordonae. Because none of the analysed patients developed any disease due to these bacteria, this event was considered a pseudo-outbreak. Investigation of the water supply system revealed that samples obtained from the recently attached aerators/rectifiers during hospital renovation tested positive for these bacteria. Therefore, measures to remove aerators/rectifiers and prevent patients from drinking tap water in the hospital were introduced. Thereafter, the frequency of NTM-positive samples significantly decreased in the hospital.Conclusion: This study is one of the few reports which reveal the possibility of pseudo-outbreaks of M. paragordonae in hospitals, hence raising the question whether aerators/rectifiers should be used in hospitals at all, because their mesh structure may pro-mote NTM proliferation in supplied water. The importance of surveillance of bacteria derived from the environment, particularly after hospital reconstruction/renovation, is re-emphasized. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society.