An outbreak of Mycobacterium mucogenicum bacteremia in pediatric hematology-oncology patients.
OBJECTIVE
Mycobacterium mucogenicum (MM) is a rapidly growing nontuberculous mycobacterium that is commonly identified in tap water that can rarely cause bacteremia. We describe an outbreak of MM bacteremia among pediatric hematology-oncology patients.


METHODS
Charts of children with MM bacteremia were retrospectively reviewed. Demographic data, underlying conditions, central venous catheter (CVC) type, duration of bacteremia, and treatment were retrieved. Epidemiologic investigation was conducted during the outbreak including environmental sampling.


RESULTS
During an 8-month period (September 2005-May 2006), 8 patients aged 1.5 to 17 years had MM bacteremia. Seven patients had underlying malignancy and 1 with thalassemia major had bone marrow transplantation. The mean number of positive blood cultures was 4.2 (1-11) per patient. Two patients received antibiotic treatment in addition to removal of CVC. All patients were cured. Almost 60 environmental samples were obtained from surfaces, ice, and municipal water supply. All were negative and no source was documented. Infection control measures included emphasis on guidelines for prevention of CVC-associated infections. No cases occurred before and after this outbreak.


CONCLUSIONS
MM is a rare agent of CVC-associated bacteremia. Removal of the CVC may be sufficient for management of bacteremia. In the absence of definite source identification, reinforcement of standard infection control measures can be successful in containing outbreaks.
Shachor-Meyouhas
Yael
Y
Infectious Diseases Unit, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel. y_shahor@rambam.health.gov.il
Sprecher
Hannah
H
Eluk
Orna
O
Ben-Barak
Ayelet
A
Kassis
Imad
I
D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002405:Catheterization, Central Venous; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D008297:Male; D009161:Mycobacterium / Q000302:isolation & purification; D009164:Mycobacterium Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D009369:Neoplasms / Q000453:epidemiology*; D012189:Retrospective Studies
D000890:Anti-Infective Agents