Mycobacterium massiliense outbreak after intramuscular injection, South Korea.
SUMMARY            We conducted an epidemic investigation to discover the route of transmission and the host factors of an outbreak of post-injection abscesses. Of the 2984 patients who visited a single clinic, 77 cases were identified and 208 age- and sex-matched controls were selected for analysis. Injected medications per se were not found to be responsible, and a deviation from safe injection practice suggested the likelihood of diluent contamination. Therefore the injected medications were classified according to whether there was a need for a diluent, and two medications showed a statistically significant association, i.e. injection with pheniramine [adjusted odds ratios (aOR) 5·93, 95% confidence interval (CI) 2·97-11·87] and ribostamycin (aOR 47·95, 95% CI 11·08-207·53). However, when considered concurrently, pheniramine lost statistical significance (aOR 8·71, 95% CI 0·44-171·61) suggesting that normal saline was the causative agent of this outbreak. Epidemiological evidence strongly suggested that this post-injection outbreak was caused by saline contaminated with Mycobacterium massiliense without direct microbiological evidence.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
H J
HJ
Kim
Y
Y
Cho
S
S
Lee
Y
Y
Kook
D
D
Lee
J
J
Lee
B J
BJ
Park
D000038:Abscess / Q000453:epidemiology* / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004340:Drug Contamination; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007273:Injections, Intramuscular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000145:classification / Q000302:isolation & purification*; D009164:Mycobacterium Infections / Q000453:epidemiology* / Q000382:microbiology; D056910:Republic of Korea / Q000453:epidemiology; D055815:Young Adult