Mycobacterium simiae outbreak associated with a hospital water supply

Nicholas G. Conger, Robert J. O'Connell, Valerie L. Laurel, Kenneth N. Olivier, Edward A. Graviss, Natalie Williams-Bouyer, Yansheng Zhang, Barbara A. Brown-Elliott, Richard J. Wallace

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

OBJECTIVE: 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. SETTlNG: 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.

Original languageEnglish (US)
Pages (from-to)1050-1055
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume25
Issue number12
DOIs
StatePublished - Dec 2004
Externally publishedYes

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Hospital Equipment and Supplies
Water Supply
Mycobacterium
Disease Outbreaks
Water
Military Facilities
Southwestern United States
Patients' Rooms
Cuba
Israel
Cross Infection
Microbiology
Lung Diseases
Medical Records

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology

Cite this

Conger, N. G., O'Connell, R. J., Laurel, V. L., Olivier, K. N., Graviss, E. A., Williams-Bouyer, N., ... Wallace, R. J. (2004). Mycobacterium simiae outbreak associated with a hospital water supply. Infection Control and Hospital Epidemiology, 25(12), 1050-1055. https://doi.org/10.1086/502342

Mycobacterium simiae outbreak associated with a hospital water supply. / Conger, Nicholas G.; O'Connell, Robert J.; Laurel, Valerie L.; Olivier, Kenneth N.; Graviss, Edward A.; Williams-Bouyer, Natalie; Zhang, Yansheng; Brown-Elliott, Barbara A.; Wallace, Richard J.

In: Infection Control and Hospital Epidemiology, Vol. 25, No. 12, 12.2004, p. 1050-1055.

Research output: Contribution to journalArticle

Conger, NG, O'Connell, RJ, Laurel, VL, Olivier, KN, Graviss, EA, Williams-Bouyer, N, Zhang, Y, Brown-Elliott, BA & Wallace, RJ 2004, 'Mycobacterium simiae outbreak associated with a hospital water supply', Infection Control and Hospital Epidemiology, vol. 25, no. 12, pp. 1050-1055. https://doi.org/10.1086/502342
Conger, Nicholas G. ; O'Connell, Robert J. ; Laurel, Valerie L. ; Olivier, Kenneth N. ; Graviss, Edward A. ; Williams-Bouyer, Natalie ; Zhang, Yansheng ; Brown-Elliott, Barbara A. ; Wallace, Richard J. / Mycobacterium simiae outbreak associated with a hospital water supply. In: Infection Control and Hospital Epidemiology. 2004 ; Vol. 25, No. 12. pp. 1050-1055.
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AU - Zhang, Yansheng

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AB - OBJECTIVE: 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. SETTlNG: 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.

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