title: Source investigation of two outbreaks of skin and soft tissue infection by Mycobacterium abscessus subsp. abscessus in Venezuela.
abstract: Outbreaks of soft tissue or skin infection due to non-tuberculous mycobacteria are reported frequently in scientific journals but in general the infection source in these outbreaks remains unknown. In Venezuela, in two distinct outbreaks, one after breast augmentation surgery and another after hydrolipoclasy therapy, 16 patients contracted a soft tissue infection due to Mycobacterium abscessus subsp. abscessus. Searching for the possible environmental infection sources in these outbreaks, initially the tap water (in the hydrolipoclasy therapy outbreak) and a surgical skin marker (in the breast implant surgery outbreak), were identified as the infection sources. Molecular typing of the strains with a variable number tandem repeat typing assay confirmed the tap water as the infection source but the molecular typing technique excluded the skin marker. We discuss the results and make a call for the implementation of stringent hygiene and disinfection guidelines for cosmetic procedures in Venezuela.
authors.affiliation: Laboratorio de Tuberculosis,Servicio Autónomo Instituto de Biomedicina 'Dr. Jacinto Convit',Caracas,Venezuela.
authors.forename: J A
authors.initials: JA
authors.lastname: Torres-Coy
authors.affiliation: Laboratorio de Tuberculosis,Servicio Autónomo Instituto de Biomedicina 'Dr. Jacinto Convit',Caracas,Venezuela.
authors.forename: B A
authors.initials: BA
authors.lastname: Rodríguez-Castillo
authors.affiliation: Facultad de Medicina,Universidad Central de Venezuela,Caracas,Venezuela.
authors.forename: R
authors.initials: R
authors.lastname: Pérez-Alfonzo
authors.affiliation: Laboratorio de Tuberculosis,Servicio Autónomo Instituto de Biomedicina 'Dr. Jacinto Convit',Caracas,Venezuela.
authors.forename: J H
authors.initials: JH
authors.lastname: DE Waard
mesh_terms: D000328:Adult; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D058889:Molecular Typing; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D017192:Skin Diseases, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D014687:Venezuela / Q000453:epidemiology; D055815:Young Adult
keywords: Breast augmentation surgery; Mycobacterium abscessus; VNTR typing; hydrolipoclasy therapy; infection source