title: Non Tuberculous Cutaneous Mycobacteriosis in a primary school in Rome: epidemiological and microbiological investigation.
abstract: During the school years 2009-2010 and 2010-2011 a total of 25 cases of Non Tuberculous Cutaneous Mycobacteriosis (NTCM) were notified in children attending the same school with a swimming pool in Rome. Environmental microbiological and epidemiological investigations (only for suspected outbreaks in 2009-2010) were conducted. We screened students with skin lesions, and environmental samples were collected from the school area and the swimming pool. During the school year 2009-10 18 cases were clinically identified among 514 primary school children (3.50%) and all cases attended the swimming pool. Only 2 out of 18 cultures were positive for Mycobacterium chelonae complex (Group III, M. abscessus). Attack Rate for swimming pool use was 13,10% (17/130), with a Relative Risk 54,70 (95% CI: 9,4 - ∞). In February 2011 additional 7 cases of cutaneous NTM among children - who attended the same primary school and swimming pool were notified to the local public health authority followed by environmental microbiological investigation. Environmental samples were positive for NTM but not for M. abscessus. Mycobacteria are not included in water-quality criteria in Italy for this reason it is important to collect evidences of NTM cases caused by these infrequent pathogens, to be able to perform rapid risk assessment and to identify the best practices in prevention and management of such a risk.
authors.affiliation: National Institute of Health, Rome, Italy.
authors.forename: F P
authors.initials: FP
authors.lastname: D'Ancona
authors.affiliation: National Institute of Health, Rome, Italy - European Programme of Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, Stockholm, Sweden.
authors.forename: E E
authors.initials: EE
authors.lastname: Kanitz
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy - Accademia Romana di Sanità Pubblica.
authors.forename: L
authors.initials: L
authors.lastname: Marinelli
authors.affiliation: San Gallicano Dermatologic Institute IRCCS, Rome, Italy.
authors.forename: J L
authors.initials: JL
authors.lastname: Sinagra
authors.affiliation: San Gallicano Dermatologic Institute IRCCS, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Prignano
authors.affiliation: Local Public Health authorities.
authors.forename: C
authors.initials: C
authors.lastname: Cerocchi
authors.affiliation: National Institute of Health, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bonadonna
authors.affiliation: Regional Reference Centre for Mycobacteria, Careggi University Hospital, Florence, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Tortoli
authors.affiliation: San Gallicano Dermatologic Institute IRCCS, Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Capitanio
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cottarelli
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy - Accademia Romana di Sanità Pubblica.
authors.forename: M
authors.initials: M
authors.lastname: De Giusti
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology*; D012384:Rome / Q000453:epidemiology; D012574:Schools; D013551:Swimming Pools