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Nagano Y, Kuronuma K, Kitamura Y, Nagano K, Yabe H, Kudo S, Sato T, Nirasawa S, Nakae M, Horiuchi M, Yokota SI, Fujiya Y, Saito A, Takahashi S, Chiba H. Pseudo-outbreak of Mycobacterium lentiflavum at a general hospital in Japan. Infect Control Hosp Epidemiol 2023; 44:1809-1815. [PMID: 37096433 PMCID: PMC10665882 DOI: 10.1017/ice.2023.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/28/2023] [Accepted: 03/15/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Mycobacterium lentiflavum is a slow-growing nontuberculous mycobacterium that is widely distributed in soil and water systems, but it is sometimes pathogenic to humans. Although cases of M. lentiflavum infections are rare, 22 isolates of M. lentiflavum were identified at a single hospital in Japan. We suspected a nosocomial outbreak; thus, we conducted transmission pattern and genotype analyses. METHODS Cases of M. lentiflavum isolated at Kushiro City General Hospital in Japan between May 2020 and April 2021 were analyzed. The patient samples and environmental culture specimens underwent whole-genome sequencing (WGS). Additionally, we retrospectively collected clinical data from patient medical records. RESULTS Altogether, 22 isolates of M. lentiflavum were identified from sputum and bronchoalveolar lavage samples. Clinically, the instances with M. lentiflavum isolates were considered contaminants. In the WGS analysis, 19 specimens, including 18 patient samples and 1 environmental culture from the hospital's faucet, showed genetic similarity. The frequency of M. lentiflavum isolation decreased after we prohibited the use of taps where M. lentiflavum was isolated. CONCLUSIONS WGS analysis identified that the cause of M. lentiflavum pseudo-outbreak was the water used for patient examinations, including bronchoscopy.
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Affiliation(s)
- Yutaro Nagano
- Department of Respiratory Medicine, Tonan Hospital, Sapporo, Japan
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Koji Kuronuma
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yasuo Kitamura
- Department of Respiratory Medicine, Kushiro City General Hospital, Kushiro, Japan
| | - Kanami Nagano
- Department of Respiratory Medicine, Kushiro City General Hospital, Kushiro, Japan
| | - Hayato Yabe
- Department of Respiratory Medicine, Kushiro City General Hospital, Kushiro, Japan
| | - Sayaka Kudo
- Department of Respiratory Medicine, Kushiro City General Hospital, Kushiro, Japan
| | - Toyotaka Sato
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
- Laboratory of Veterinary Hygiene, Hokkaido University School of Veterinary Medicine, Sapporo, Japan
- Graduate School of Infectious Diseases, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Shinya Nirasawa
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Mami Nakae
- Division of Infection Control, Sapporo Medical University Hospital, Sapporo, Japan
| | - Motohiro Horiuchi
- Laboratory of Veterinary Hygiene, Hokkaido University School of Veterinary Medicine, Sapporo, Japan
- Graduate School of Infectious Diseases, Hokkaido University, Sapporo, Japan
- One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Shin-ichi Yokota
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yoshihiro Fujiya
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Atsushi Saito
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
- Division of Infection Control, Sapporo Medical University Hospital, Sapporo, Japan
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirofumi Chiba
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Jinah R, Ryan T, Sibbald M. A Case of Pericarditis and Pericardial Masses Associated With Mycobacterium Paragordonae. Clin Med Insights Cardiol 2023; 17:11795468231189039. [PMID: 37637260 PMCID: PMC10460162 DOI: 10.1177/11795468231189039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 06/23/2023] [Indexed: 08/29/2023]
Abstract
Tuberculosis is a common cause of pericarditis worldwide and has been associated with pericardial masses. Non-tuberculous mycobacteria are uncommonly associated with cardiac disease, having primarily been described in cases of endocarditis. Here we describe a case of an immunocompetent patient with Mycobacterium paragordonae infection causing pericarditis with a large effusion containing pericardial masses. The patient presented with chest pain, hypoxia and biochemical evidence of inflammation (CRP 216.1 mg/L). This report illustrates a rare case of pericarditis with pericardial masses associated with non-tuberculous mycobacteria and the first example of pericarditis associated with M. paragordonae.
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Affiliation(s)
| | | | - Matthew Sibbald
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Fukano H, Kazumi Y, Sakagami N, Fujiwara N, Ato M, Mitarai S, Hoshino Y. Mycobacterium kiyosense sp. nov., a scotochromogenic slow-glowing species isolated from respiratory specimens. Int J Syst Evol Microbiol 2023; 73. [PMID: 37339072 DOI: 10.1099/ijsem.0.005917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023] Open
Abstract
Scotochromogenic slow-growing mycobacteria were isolated from the sputum or bronchoalveolar lavage fluid of 12 patients in Japan. From a comparison of the whole-genome sequences, the representative strain IWGMT90018-18076T and the unknown strains obtained from the patients were found to represent a novel species related to the Mycobacterium gordonae complex. The average nucleotide identity values of IWGMT90018-18076T with Mycobacterium vicinigordonae, Mycobacterium paragordonae and M. gordonae were 86.7, 82.5 and 82.2 %, respectively. The genome size of the representative strain IWGMT90018-18076T was approximately 6.3 Mbp, and the genomic DNA G+C content was 67.1 %. The major fatty acid methyl esters were C16 : 0 (37.71 %), C18 : 1ω9c (29.5 %) and C16 : 1ω7c (10.32 %). In this study, we performed phylogenetic analyses, physiological and biochemical characteristic tests, drug susceptibility tests and fatty acid profiling of the clinical isolates. On the basis of the results obtained, we propose that the unknown clinical isolates represent a novel species, 'Mycobacterium kiyosense sp. nov,' with the type strain being IWGMT90018-18076T (=JCM 34837T =KCTC 49725T).
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Affiliation(s)
- Hanako Fukano
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
| | - Yuko Kazumi
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
| | | | - Nagatoshi Fujiwara
- Department of Food and Nutrition, Tezukayama University, 7-1-1 Gakuen-minami, Nara, Japan
| | - Manabu Ato
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
| | - Satoshi Mitarai
- Research Institute of Tuberculosis, Japan Anti-tuberculosis Association, 3-1-24 Matsuyama, Kiyose, Tokyo, Japan
| | - Yoshihiko Hoshino
- Department of Mycobacteriology, Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1 Aoba, Higashi-Murayama, Tokyo, Japan
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Cha GY, Seo H, Oh J, Kim BJ, Kim BJ. Potential Use of Mycobacterium paragordonae for Antimycobacterial Drug Screening Systems. J Microbiol 2023; 61:121-9. [PMID: 36719620 DOI: 10.1007/s12275-022-00009-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/20/2022] [Accepted: 11/25/2022] [Indexed: 02/01/2023]
Abstract
Our recent genome-based study indicated that Mycobacterium paragordonae (Mpg) has evolved to become more adapted to an intracellular lifestyle within free-living environmental amoeba and its enhanced intracellular survival within Acanthamoeba castellanii was also proved. Here, we sought to investigate potential use of Mpg for antimycobacterial drug screening systems. Our data showed that Mpg is more susceptible to various antibiotics compared to the close species M. marinum (Mmar) and M. gordonae, further supporting its intracellular lifestyle in environments, which would explain its protection from environmental insults. In addition, we developed two bacterial whole-cell-based drug screening systems using a recombinant Mpg stain harboring a luciferase reporter vector (rMpg-LuxG13): one for direct application to rMpg-LuxG13 and the other for drug screening via the interaction of rMpg-LuxG13 with A. castellanii. Direct application to rMpg-LuxG13 showed lower inhibitory concentration 50 (IC50) values of rifampin, isoniazid, clarithromycin, and ciprofloxacin against Mpg compared to Mmar. Application of drug screening system via the interaction of rMpg-LuxG13 with A. castellanii also exhibited lower IC50 values for rifampin against Mpg compared to Mmar. In conclusion, our data indicate that Mpg is more susceptible to various antibiotics than other strains. In addition, our data also demonstrate the feasibility of two whole cell-based drug screening systems using rMpg-LuxG13 strain for the discovery of novel anti-mycobacterial drugs.
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Inagaki H, Goto Y, Sugiyama H, Saito A, Okabayashi T, Watanabe K, Fujimoto S. Usefulness of a new DUV-LED device for the control of infection by Escherichia coli, Staphylococcus aureus, mycobacteria and spore-forming bacteria. Front Public Health 2022; 10:1053729. [PMID: 36544797 PMCID: PMC9760979 DOI: 10.3389/fpubh.2022.1053729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
Reliable disinfection and sterilization technologies are needed to deal with the various infectious diseases spreading around the world. Furthermore, bacteria that are difficult to eliminate by ordinary disinfection are also a problem in the medical environment. We examined the germicidal effect of a newly developed deep-ultraviolet light-emitting diode (DUV-LED) prototype device (wavelength of 280 ± 5 nm; power of 0.9 to 1.4 mW/cm2) for floor sterilization against Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), Mycobacterium gordonae (M. gordonae), and Bacillus subtilis (B. subtilis). This prototype device is equipped with highly practical DUV-LEDs with a high output efficiency and a long life, and was designed with consideration of the irradiation distance and the angle of the DUV-LEDs to provide a uniform irradiation rate. We found a statistically significant reduction of ≥90% in the infectious titers of both E. coli and S. aureus after irradiation for 2 s. Although acid-fast bacilli and spore-type bacilli are generally thought to be resistant to UV light irradiation compared to general bacteria, the acid-fast bacillus M. gordonae was inactivated after irradiation for 10 s, and spore-type cells of the bacillus B. subtilis were inactivated by ≥90% after irradiation for 30 s. We also found that the effects were cumulative when irradiation was performed at intervals. In the future, the usefulness of this device as an infection control measure will be evaluated in daily medical practice.
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Affiliation(s)
- Hiroko Inagaki
- M&N Collaboration Research Laboratory, Department of Medical Environment Innovation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yoshitaka Goto
- M&N Collaboration Research Laboratory, Department of Medical Environment Innovation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hironobu Sugiyama
- M&N Collaboration Research Laboratory, Department of Medical Environment Innovation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan,Nikkiso Co., Ltd., Tokyo, Japan
| | - Akatsuki Saito
- Department of Veterinary Science, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan,Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | - Tamaki Okabayashi
- Department of Veterinary Science, Faculty of Agriculture, University of Miyazaki, Miyazaki, Japan,Center for Animal Disease Control, University of Miyazaki, Miyazaki, Japan
| | | | - Shouichi Fujimoto
- M&N Collaboration Research Laboratory, Department of Medical Environment Innovation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan,*Correspondence: Shouichi Fujimoto
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Shen Y, Haig SJ, Prussin AJ, LiPuma JJ, Marr LC, Raskin L. Shower water contributes viable nontuberculous mycobacteria to indoor air. PNAS Nexus 2022; 1:pgac145. [PMID: 36712351 PMCID: PMC9802317 DOI: 10.1093/pnasnexus/pgac145] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 11/07/2022] [Indexed: 11/11/2022]
Abstract
Nontuberculous mycobacteria (NTM) are frequently present in municipal drinking water and building plumbing, and some are believed to cause respiratory tract infections through inhalation of NTM-containing aerosols generated during showering. However, the present understanding of NTM transfer from water to air is insufficient to develop NTM risk mitigation strategies. This study aimed to characterize the contribution of shower water to the abundance of viable NTM in indoor air. Shower water and indoor air samples were collected, and 16S rRNA and rpoB genes were sequenced. The sequencing results showed that running the shower impacted the bacterial community structure and NTM species composition in indoor air by transferring certain bacteria from water to air. A mass balance model combined with NTM quantification results revealed that on average 1/132 and 1/254 of NTM cells in water were transferred to air during 1 hour of showering using a rain and massage showerhead, respectively. A large fraction of the bacteria transferred from water to air were membrane-damaged, i.e. they had compromised membranes based on analysis by live/dead staining and flow cytometry. However, the damaged NTM in air were recoverable as shown by growth in a culture medium mimicking the respiratory secretions of people with cystic fibrosis, implying a potential infection risk by NTM introduced to indoor air during shower running. Among the recovered NTM, Mycobacterium mucogenicum was the dominant species as determined by rpoB gene sequencing. Overall, this study lays the groundwork for future pathogen risk management and public health protection in the built environment.
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Affiliation(s)
| | | | - Aaron J Prussin
- Department of Civil and Environmental Engineering, Virginia Tech, 418 Durham Hall, Blacksburg, VA 24061, USA
| | - John J LiPuma
- Department of Pediatrics, University of Michigan Medical School, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
| | - Linsey C Marr
- Department of Civil and Environmental Engineering, Virginia Tech, 418 Durham Hall, Blacksburg, VA 24061, USA
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Yuanchun L, Wenping Z, Jing Z, Wenjie L, Yanlin Z, Yanming L, Jiuxin Q. Mycobacterium paragordonae is an emerging pathogen in human pulmonary disease: clinical features, antimicrobial susceptibility testing and outcomes. Emerg Microbes Infect 2022; 11:1973-1981. [PMID: 35916253 PMCID: PMC9364734 DOI: 10.1080/22221751.2022.2103453] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectives: Mycobacterium paragordonae (MPG) is an emerging and less common type of Non-tuberculous mycobacteria (NTM) and we know little about its characteristics and prognosis, hence we constructed this retrospective cohort study. Methods: MPG was identified using MALD-TOF MS, multi-target combined gene sequencing and WGS. Clinical information was collected, antimicrobial susceptibility testing was measured using the SLOMYCO panel, and optimal growth temperature testing was measured using Lowenstein-Jensen medium. Results: Eight MPGs were isolated from 1730 NTMs (0.46%); the mean age of MPG pulmonary disease (MPG-PD) patients was 42.38 ± 9.92 years, 37.5% were male, and the average BMI was 18.4 ± 0.51 kg/m2. All patients had the symptoms of cough and sputum and CT images mainly presented in patchy or streaky shadows, MPG grew at 25°C, 30°C and 37°C, and the optimal growth temperature is 37°C. MPGs were sensitive to clarithromycin, rifabutin, amikacin, linezolid, moxifloxacin, cotrimoxazole and ciprofloxacin, two isolates were resistant to rifampicin. Two patients had follow up information, their imaging remained stable during the follow-up. Conclusions: MPG-PD is a rare NTM disease and is more likely to develop in middle-aged, female, and low BMI patients. The patients present with no specific features within the symptoms as well as the CT imaging. The optimal growth temperature of MPG is at 37°C, MPG-PD has excellent sensitivity to drugs recommended by CLSI and presents with a stable disease.
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Affiliation(s)
- Li Yuanchun
- Department of Clinical Laboratory, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
| | - Zhang Wenping
- Department of Clinical Laboratory, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
| | - Zhao Jing
- Department of Medical Imaging, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
| | - Lai Wenjie
- Department of Clinical Laboratory, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
| | - Zhao Yanlin
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention. Beijing, P.R. China
| | - Li Yanming
- Department of Pulmonary and Critical Care Medicine, Beijing Hospital, National Center of Gerontology, National Health Commission; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Qu Jiuxin
- Department of Clinical Laboratory, The Third People's Hospital of Shenzhen, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, Guangdong Provincial Clinical Research Center for Infectious Diseases (Tuberculosis), Shenzhen Clinical Research Center for Tuberculosis, Shenzhen, China
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Kaul CM, Chan J, Phillips MS. Mitigation of nontuberculous mycobacteria in hospital water: challenges for infection prevention. Curr Opin Infect Dis 2022; 35:330-8. [PMID: 35849523 DOI: 10.1097/QCO.0000000000000844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize recent literature on nontuberculous mycobacteria in water of healthcare systems. Despite improvement in identification techniques and emergence of infection prevention and control programs, nontuberculous mycobacteria remain present in hospital water systems, causing outbreaks and pseudo-outbreaks in healthcare settings. RECENT FINDINGS Waterborne outbreaks and pseudo-outbreaks of nontuberculous mycobacteria continue to affect hospitals. Improvements in methods of identification and investigation, including MALDI-TOF and whole genome sequencing with evaluation of single nucleotide polymorphisms, have been used successfully in outbreak and pseudo-outbreak investigations. Recent studies have shown control of outbreaks in immunocompromised patients through the use of sterile water for consumption, as well as control of pseudo-outbreaks by using sterile water for procedures. Construction activities have been implicated in outbreaks and pseudo-outbreaks of nontuberculous mycobacteria. Water management programs are now required by the Joint Commission, which will likely improve water risk mitigation. SUMMARY Improvement in detection and identification of nontuberculous mycobacteria has led to increasing recognition of waterborne outbreaks and pseudo-outbreaks. Water management programs are of vital importance in infection prevention.
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Walker JT, Bak A, Marsden G, Spencer W, Griffiths H, Stanton GA, Williams C, White LJ, Ross E, Sjogren G, Bradley CW, Garvey M. Final rinse water quality for flexible endoscopy to minimise the risk of post-endoscopic infection. Report from Healthcare Infection Society Working Party. J Hosp Infect 2022; 124:79-96. [PMID: 35276281 DOI: 10.1016/j.jhin.2022.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/02/2022] [Indexed: 01/10/2023]
Affiliation(s)
- James T Walker
- Central Sterilising Club, UK; Healthcare Infection Society, London, UK
| | - Aggie Bak
- Healthcare Infection Society, London, UK.
| | | | - Wayne Spencer
- Authorising Engineer, Spencer Nickson Ltd, Frodsham, UK
| | - Helen Griffiths
- Decontamination and TSE advisor, British Society of Gastroenterology, London, UK
| | | | - Craig Williams
- Healthcare Infection Society, London, UK; Consultant Microbiologist, University Hospitals of Morecambe Bay, UK
| | - Leila J White
- Healthcare Infection Society, London, UK; Lancashire Teaching Hospitals NHS Foundation Trusts, UK
| | - Elaine Ross
- Healthcare Infection Society, London, UK; Infection Prevention Society, Seafield, UK
| | - Geoff Sjogren
- Western Sussex Hospitals NHS Foundation Trust (retired), UK
| | - Christina W Bradley
- Healthcare Infection Society, London, UK; University Hospitals Birmingham NHS Foundation Trust, UK
| | - Mark Garvey
- Healthcare Infection Society, London, UK; University Hospitals Birmingham NHS Foundation Trust, UK
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Mei YM, Zhang Q, Zhang WY, Jiang HQ, Shi Y, Xiong JS, Wang L, Chen YQ, Long SY, Pan C, Ge G, Wang ZZ, Wu ZW, Wang Y, Jiang YQ, Wang HS. Isolation of Novel Mycobacterium Species from Skin Infection in an Immunocompromised Person. Emerg Infect Dis 2021; 27:2944-2947. [PMID: 34670653 PMCID: PMC8544998 DOI: 10.3201/eid2711.210426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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11
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Mei YM, Zhang Q, Zhang WY, Jiang HQ, Shi Y, Xiong JS, Wang L, Chen YQ, Long SY, Pan C, Ge G, Wang ZZ, Wu ZW, Wang Y, Jiang YQ, Wang HS. Isolation of Novel Mycobacterium Species from Skin Infection in an Immunocompromised Person. Emerg Infect Dis 2021. [PMID: 34670653 DOI: 10.3201//eid2711.210426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated a case of cutaneous infection in an immunocompromised patient in China that was caused by a novel species within the Mycobacterium gordonae complex. Results of whole-genome sequencing indicated that some strains considered to be M. gordonae complex are actually polyphyletic and should be designated as closely related species.
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Benoit MÈ, Prévost M, Succar A, Charron D, Déziel E, Robert E, Bédard E. Faucet aerator design influences aerosol size distribution and microbial contamination level. Sci Total Environ 2021; 775:145690. [PMID: 33631571 DOI: 10.1016/j.scitotenv.2021.145690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
Faucet aerators have been linked to multiple opportunistic pathogen outbreaks in hospital, especially Pseudomonas aeruginosa, their complex structure promoting biofilm development. The importance of bacteria aerosolization by faucet aerators and their incidence on the risk of infection remain to be established. In this study, ten different types of aerators varying in complexity, flow rates and type of flow were evaluated in a controlled experimental setup to determine the production of aerosols and the level of contamination. The aerosol particle number density and size distribution were assessed using a particle spectrometer. The bacterial load was quantified with a 14-stage cascade impactor, where aerosol particles were captured and separated by size, then analysed by culture and flow cytometry. The water was seeded with Pseudomonas fluorescens as a bacterial indicator. Aerosol particle size and mean mass distribution varied depending on the aerator model. Devices without aeration or with laminar flow produced the lowest number and mass of aerosol particles when measured with spectrometry. Models with aeration displayed wide differences in their potential production of aerosol particles. A new aerator with a low flow, no air inlet in its structure, and a spray stream produced 12 to 395 times fewer aerosol particles containing bacteria. However, the impact of low flow on biofilm development and incorporation of pathogens should be further investigated. Repeated use of aerators resulted in fouling which increased the quantity of bacteria released through aerosol particles. An in-depth mechanical cleaning including complete dismantling of the aerator was required to recover initial performances. Aerators should be selected to minimize aerosol production, considering the ease of maintenance and the main water usage at each sink. Low flow aerators produced a lower number of contaminated aerosol particles when new but may be more susceptible to fouling and quickly lose their initial advantage.
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Affiliation(s)
- Marie-Ève Benoit
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Michèle Prévost
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Antonella Succar
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Dominique Charron
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Eric Déziel
- Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique (INRS), Laval, QC, Canada
| | - Etienne Robert
- Department of Mechanical Engineering, Polytechnique Montréal, Montréal, QC, Canada
| | - Emilie Bédard
- Department of Civil Engineering, Polytechnique Montréal, Montréal, QC, Canada.
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Proctor CR, Rhoads WJ, Keane T, Salehi M, Hamilton K, Pieper KJ, Cwiertny DM, Prévost M, Whelton AJ. Considerations for large building water quality after extended stagnation. AWWA Water Sci 2020; 2:e1186. [PMID: 32838226 DOI: 10.31219/osf.io/qvj3b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 05/25/2023]
Abstract
The unprecedented number of building closures related to the coronavirus disease (COVID-19) pandemic is concerning because water stagnation will occur in many buildings that do not have water management plans in place. Stagnant water can have chemical and microbiological contaminants that pose potential health risks to occupants. Health officials, building owners, utilities, and other entities are rapidly developing guidance to address this issue, but the scope, applicability, and details included in the guidance vary widely. To provide a primer of large building water system preventative and remedial strategies, peer-reviewed, government, industry, and nonprofit literature relevant to water stagnation and decontamination practices for plumbing was synthesized. Preventative practices to help avoid the need for recommissioning (e.g., routine flushing) and specific actions, challenges, and limitations associated with recommissioning were identified and characterized. Considerations for worker and occupant safety were also indicated. The intended audience of this work includes organizations developing guidance.
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Affiliation(s)
- Caitlin R Proctor
- Division of Environmental and Ecological Engineering, Lyles School of Civil Engineering, Weldon School of Biomedical Engineering, School of Materials Engineering Purdue University West Lafayette Indiana
| | - William J Rhoads
- Department of Civil and Environmental Engineering Virginia Tech Blacksburg Virginia
| | - Tim Keane
- Legionella Risk Management, Inc. Chalfont Pennsylvania
| | - Maryam Salehi
- Department of Civil Engineering University of Memphis Memphis Tennessee
| | - Kerry Hamilton
- School of Sustainable Engineering and the Built Environment Arizona State University Tempe Arizona
| | - Kelsey J Pieper
- Department of Civil and Environmental Engineering Northeastern University Boston Massachusetts
| | - David M Cwiertny
- Department of Civil and Environmental Engineering, Seamans Center for the Engineering Arts and Sciences University of Iowa Iowa City Iowa
- Center for Health Effects of Environmental Contamination University of Iowa Iowa City Iowa
- Public Policy Center University of Iowa Iowa City Iowa
| | - Michele Prévost
- Civil, Geological and Mining Engineering Polytechnique Montreal Montréal Québec Canada
| | - Andrew J Whelton
- Lyles School of Civil Engineering, Division of Environmental and Ecological Engineering Purdue University West Lafayette Indiana
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Proctor CR, Rhoads WJ, Keane T, Salehi M, Hamilton K, Pieper KJ, Cwiertny DM, Prévost M, Whelton AJ. Considerations for Large Building Water Quality after Extended Stagnation. ACTA ACUST UNITED AC 2020; 2:e1186. [PMID: 32838226 PMCID: PMC7323006 DOI: 10.1002/aws2.1186] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 01/04/2023]
Abstract
The unprecedented number of building closures related to the coronavirus disease (COVID‐19) pandemic is concerning because water stagnation will occur in many buildings that do not have water management plans in place. Stagnant water can have chemical and microbiological contaminants that pose potential health risks to occupants. Health officials, building owners, utilities, and other entities are rapidly developing guidance to address this issue, but the scope, applicability, and details included in the guidance vary widely. To provide a primer of large building water system preventative and remedial strategies, peer‐reviewed, government, industry, and nonprofit literature relevant to water stagnation and decontamination practices for plumbing was synthesized. Preventative practices to help avoid the need for recommissioning (e.g., routine flushing) and specific actions, challenges, and limitations associated with recommissioning were identified and characterized. Considerations for worker and occupant safety were also indicated. The intended audience of this work includes organizations developing guidance.
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Affiliation(s)
- Caitlin R Proctor
- Division of Environmental and Ecological Engineering, Lyles School of Civil Engineering, Weldon School of Biomedical Engineering, School of Materials Engineering Purdue University West Lafayette IN
| | - William J Rhoads
- Department of Civil and Environmental Engineering Virginia Tech Blacksburg VA
| | - Tim Keane
- Consulting Engineer, Legionella Risk Management, Inc PA
| | - Maryam Salehi
- Department of Civil Engineering University of Memphis Memphis TN
| | - Kerry Hamilton
- School of Sustainable Engineering and the Built Environment Arizona State University Tempe AZ
| | - Kelsey J Pieper
- Department of Civil and Environmental Engineering Northeastern University Boston MA
| | - David M Cwiertny
- Department of Civil & Environmental Engineering, 4105 Seamans Center for the Engineering Arts and Sciences University of Iowa Iowa City IA.,Center for Health Effects of Environmental Contamination, 251 North Capitol Street, Chemistry Building - Room W195 University of Iowa Iowa City IA.,Public Policy Center, 310 South Grand Ave, 209 South Quadrangle University of Iowa Iowa City IA
| | - Michele Prévost
- Professor and Principal Chairholder, NSERC Industrial Chair on Drinking Water, Civil, Geological and Mining Engineering, Polytechnique Montreal CP Québec Canada
| | - Andrew J Whelton
- Purdue University, Lyles School of Civil Engineering, Division of Environmental and Ecological Engineering West Lafayette IN
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