title: Pseudo-outbreak of Mycobacterium gordonae Following the Opening of a newly constructed hospital at a Chicago Medical Center.
abstract: OBJECTIVE To identify the source of a pseudo-outbreak of Mycobacterium gordonae DESIGN Outbreak investigation. SETTING University Hospital in Chicago, Ilinois. PATIENTS Hospital patients with M. gordonae-positive clinical cultures. METHODS An increase in isolation of M. gordonae from clinical cultures was noted immediately following the opening of a newly constructed hospital in January 2012. We reviewed medical records of patients with M. gordonae-positive cultures collected between January and December 2012 and cultured potable water specimens in new and old hospitals quantitatively for mycobacteria. RESULTS Of 30 patients with M. gordonae-positive clinical cultures, 25 (83.3%) were housed in the new hospital; of 35 positive specimens (sputum, bronchoalveolar lavage, gastric aspirate), 32 (91.4%) had potential for water contamination. M. gordonae was more common in water collected from the new vs. the old hospital [147 of 157 (93.6%) vs. 91 of 113 (80.5%), P=.001]. Median concentration of M. gordonae was higher in the samples from the new vs. the old hospital (208 vs. 48 colony-forming units (CFU)/mL; P<.001). Prevalence and concentration of M. gordonae were lower in water samples from ice and water dispensers [13 of 28 (46.4%) and 0 CFU/mL] compared with water samples from patient rooms and common areas [225 of 242 (93%) and 146 CFU/mL, P<.001]. CONCLUSIONS M. gordonae was common in potable water. The pseudo-outbreak of M. gordonae was likely due to increased concentrations of M. gordonae in the potable water supply of the new hospital. A silver ion-impregnated 0.5-μm filter may have been responsible for lower concentrations of M. gordonae identified in ice/water dispenser samples. Hospitals should anticipate that construction activities may amplify the presence of waterborne nontuberculous mycobacterial contaminants.
authors: 1University of Colorado,Aurora,CO,USA.
authors: Kavitha
authors: K
authors: Prabaker
authors: 2Metro Infectious Disease Consultants,Chicago,IL,USA.
authors: Chethra
authors: C
authors: Muthiah
authors: 3Rush University Medical Center,Chicago,IL,USA.
authors: Mary K
authors: MK
authors: Hayden
authors: 3Rush University Medical Center,Chicago,IL,USA.
authors: Robert A
authors: RA
authors: Weinstein
authors: 3Rush University Medical Center,Chicago,IL,USA.
authors: Jyothirmai
authors: J
authors: Cheerala
authors: 3Rush University Medical Center,Chicago,IL,USA.
authors: Mary L
authors: ML
authors: Scorza
authors: 3Rush University Medical Center,Chicago,IL,USA.
authors: John
authors: J
authors: Segreti
authors: 5Saint Anthony Hospital,Chicago,IL,USA.
authors: Mary A
authors: MA
authors: Lavin
authors: 3Rush University Medical Center,Chicago,IL,USA.
authors: Barbara A
authors: BA
authors: Schmitt
authors: 4Cook County Health and Hospital Systems,Chicago,IL,USA.
authors: Sharon F
authors: SF
authors: Welbel
authors: 6University of Chicago,Chicago,IL,USA.
authors: Kathleen G
authors: KG
authors: Beavis
authors: 3Rush University Medical Center,Chicago,IL,USA.
authors: Gordon M
authors: GM
authors: Trenholme
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D002641:Chicago / Q000453:epidemiology; D015169:Colony Count, Microbial; D004196:Disease Outbreaks; D060766:Drinking Water / Q000382:microbiology; D005750:Gastric Juice / Q000382:microbiology; D006785:Hospitals, University; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology; D009170:Nontuberculous Mycobacteria; D013183:Sputum / Q000382:microbiology; D014871:Water Microbiology
chemical_list: D060766:Drinking Water