title: Mycobacterium abscessus pseudoinfection traced to an automated endoscope washer: utility of epidemiologic and laboratory investigation.
abstract: After 15 patients had positive cultures for Mycobacterium abscessus without evidence of infection (i.e., pseudoinfection) following endoscopy, retrospective cohort studies of patients undergoing endoscopy and microbiologic sampling of the environment were done to examine potential nosocomial transmission and to identify the source and risk factors for M. abscessus pseudoinfection. In the epidemic period, M. abscessus-positive cultures were significantly more likely to be obtained during bronchoscopy than gastroendoscopy (16/149 vs. 1/860, P < .001) and during procedures using bronchoscopes disinfected in an automated washer rather than by other methods (16/54 vs. 0/95, P < .001). M. abscessus was recovered from the automated washer, the inlet water feeding the washer, and a flexible bronchoscope. Environmental and case-patient isolates had identical large restriction fragment (LRF) patterns of genomic DNA separated by pulsed-field gel electrophoresis. Molecular typing using LRF analysis supported the epidemiologic results and demonstrate the utility of combined epidemiologic and laboratory investigations in nosocomial outbreaks of nontuberculous mycobacteria.
authors.affiliation: Hospital Infectious Program, Centers for Disease Control and Prevention, Atlanta, Georgia 30333.
authors.forename: S
authors.initials: S
authors.lastname: Maloney
authors.forename: S
authors.initials: S
authors.lastname: Welbel
authors.forename: B
authors.initials: B
authors.lastname: Daves
authors.forename: K
authors.initials: K
authors.lastname: Adams
authors.forename: S
authors.initials: S
authors.lastname: Becker
authors.forename: L
authors.initials: L
authors.lastname: Bland
authors.forename: M
authors.initials: M
authors.lastname: Arduino
authors.forename: R
authors.initials: R
authors.lastname: Wallace
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: G
authors.initials: G
authors.lastname: Buck
mesh_terms: D000328:Adult; D001999:Bronchoscopy / Q000009:adverse effects*; D002648:Child; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D004866:Equipment Contamination; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D009164:Mycobacterium Infections / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors