Rapidly growing mycobacteria among pediatric hematopoietic cell transplant patients traced to the hospital water supply.
BACKGROUND
Rapidly growing mycobacteria (RGM) have a predilection for those with immunocompromised states. We report increased isolation of RGM among pediatric hematopoietic cell transplant patients that was traced to the hospital water supply.


METHODS
Cases of RGM-positive patients were differentiated based on whether they were community-acquired or nosocomial, colonized or infected based on predefined criteria. Medical records of all RGM-positive patients were reviewed and data extracted. Infection control outbreak measures were instituted and an environmental investigation was conducted.


RESULTS
Between July 2011 and April 2012, 16 RGM isolates were identified among 15 hematopoietic cell transplant patients, compared with none in the preceding year. After environmental samples were initially grown on media for heterotrophic counts and further speciated, RGM species were identified in the hospital water supply.


CONCLUSIONS
This outbreak of RGM was traced to an environmental source and was successfully controlled through institution of infection control measures.
From the *Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Amplatz Children's Hospital; †Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota; ‡Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation, University of Minnesota Amplatz Children's Hospital; §University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children's Hospital, Minneapolis, MN, USA; ¶Department of Environmental Health; and ‖Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
Pui-Ying
PY
Iroh Tam
Susan
S
Kline
John E
JE
Wagner
Amanda
A
Guspiel
Andrew
A
Streifel
Ginger
G
Ward
Keith
K
Messinger
Patricia
P
Ferrieri
D000293:Adolescent; D002648:Child; D004196:Disease Outbreaks; D018380:Hematopoietic Stem Cell Transplantation; D006761:Hospitals; D006801:Humans; D017053:Infection Control; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D066027:Transplant Recipients; D014871:Water Microbiology; D014881:Water Supply; D055815:Young Adult