title: Pseudo-outbreak of Mycobacterium gordonae in a teaching hospital: importance of strictly following decontamination procedures and emerging issues concerning sterilization.
abstract: Aim of this study was to investigate a pseudo-outbreak of Mycobacterium gordonae analyzing isolates detected from clinical and environmental samples. Mycobacterium gordonae was detected in 7 out of 497 broncho-alveolar lavage (BAL) samples after bronchoscopy procedure in patients admitted to a teaching hospital between January and April 2013. During this pseudo-outbreak clinical, epidemiological, environmental and molecular investigations were performed. None of the patients met the criteria for non-tuberculous mycobacterial (NTM) lung disease and were treated for M. gordonae lung disease. Environmental investigation revealed M. gordonae in 3 samples: in tap water and in the water supply channel of the washer disinfector. All the isolates were subjected to genotyping by pulsed-field gel electrophoresis (PFGE). The PFGE revealed that only patients' isolates presented the same band pattern but no correlation with the environmental strain was detected. Surveillance of the outbreak and the strict adherence to the reprocessing procedure and its supplies resulted afterwards in no detection of M. gordonae in clinical respiratory samples. Clinical surveillance of patients was crucial to establish the start of NTM treatment. Regular screening of tap water and endoscopic equipment should be adopted to compare the clinical strains with the environmental ones when an outbreak occurs.
authors.affiliation: Infectious Diseases Unit, Department Public Health and Infectious Disease, "Sapienza" University of Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Scorzolini
authors.affiliation: Infectious Diseases Unit, Department Public Health and Infectious Disease, "Sapienza" University of Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Mengoni
authors.affiliation: Infectious Diseases Unit, Department Public Health and Infectious Disease, "Sapienza" University of Rome, Italy.
authors.forename: Claudio M
authors.initials: CM
authors.lastname: Mastroianni
authors.affiliation: Emerging Bacterial Pathogens Unit, Department of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Baldan
authors.affiliation: Emerging Bacterial Pathogens Unit, Department of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Daniela M
authors.initials: DM
authors.lastname: Cirillo
authors.affiliation: Hygiene Unit, Department Public Health and Infectious Disease, "Sapienza" University of Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: De Giusti
authors.affiliation: Hygiene Unit, Department Public Health and Infectious Disease, "Sapienza" University of Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Marinelli
authors.affiliation: Hygiene Unit, Department Public Health and Infectious Disease, "Sapienza" University of Rome, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Cottarelli
authors.affiliation: Department of Infectious, Parasitic and Immune-Mediated Diseases, Italian National Institute of Health, Rome, Italy.
authors.forename: Lanfranco
authors.initials: L
authors.lastname: Fattorini
authors.affiliation: Infectious Diseases Unit, Department Public Health and Infectious Disease, "Sapienza" University of Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vullo
mesh_terms: D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D003666:Decontamination / Q000592:standards*; D004196:Disease Outbreaks; D016521:Electrophoresis, Gel, Pulsed-Field; D004784:Environmental Monitoring; D004866:Equipment Contamination; D005838:Genotype; D006784:Hospitals, Teaching; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology* / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D013242:Sterilization / Q000592:standards; D014871:Water Microbiology; D014881:Water Supply / Q000592:standards
keywords: Broncoschopy; Mycobacterium gordonae; Pseudo-outbreak; Pulsed-field gel electrophoresis