Hospital outbreak of atypical mycobacterial infection of port sites after laparoscopic surgery

Vijayaraghavan, R.; Chandrashekhar, R.; Sujatha, Y; Belagavi, C. S.

doi:10.1016/j.jhin.2006.07.021

Cited by 86 publications

(53 citation statements)

References 14 publications

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“…This is best achieved by using an ultrasonic technology which is available in some hospitals. , Secondly, it is necessary to limit glutaraldehyde disinfectants and replace it with ethylene oxide gas sterilization, as this has been shown to be highly effective in reducing atypical mycobacterial infections following laparoscopy [18]. When liquid chemical sterilants are used, higher concentrations (3.4%) must be used and the exposure time should be increased to 8-12 hours to activate sporicidal activity.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Atypical Mycobacterial Infection after Laparoscopic Surgery

2010

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Atypical mycobacterial infections at the laparoscopic port site are a frequent problem encountered in patients undergoing laparoscopic surgery. In this study we concentrate on the clinical diagnosis, management and prevention of this problem. In this series we assess 19 patients presenting with port hole infections after laparoscopic surgery and were treated with a combination of oral clarithromycin and ciprofloxacin. Seven patients who had persistent nodules were given injections of amikacin directly into the infection foci along with standard oral therapy. Most of the patients treated with standard oral therapy for 28 days showed recovery. The patients with persistent nodules 4 weeks after completion of therapy were treated with injections of amikacin directly into the nodule which lead to resolution of symptoms. For prevention of infection, proper sterilization and storage of instruments is recommended. Laparoscopic port hole infections is a preventable problem and can also be treated by nonsurgical method.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and Management of Atypical Mycobacterial Infection after Laparoscopic Surgery

2010

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“…Post laparoscopic surgery one can expect 2 types of infection; one within a week of surgery and another 3-4 weeks later which is mostly caused by NTM organisms [1]. In laparoscopic procedures the commonest site for infection is the umbilical port site and the second most commonly affected site is the epigastric port, from there it spreads to other port sites.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis is usually made from the tissue culture which takes about 3-4 weeks. So these days the early and newer diagnostic methods a such as BACTEC and RT-PCR is considered [1,2]. Clinical diagnosis is the best considered option.…”

Section: Discussionmentioning

confidence: 99%

Non Tuberculous Mycobacterium as a Causative Factor in Port Site Wound Infection - A Case Report

Rajkumar¹

2018

SMOAJ

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Over the two decades there has been an increase in Non Tuberculous Mycobacterium (NTM) organisms in post laparoscopic port site skin and soft tissue infections. Presenting a patient who underwent eight successive surgical explorations of multiple skin and soft tissue sinuses and for aggressive necrosectomy and debridement of multiple sinuses caused by NTM organisms which ended up in abdominoplasty and meshplasty 2 months after the infection had been completely controlled. She finally had complete relief from the infection and had 6 months follow up from the last meshplasty surgery. The presentation and treatment of NTM skin and soft tissue infection are briefly outlined.

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“…Previous post-laparoscopic infections by mycobacteria have been described as isolated cases or limited outbreaks 2,15,16 . Surgical site infections related to M. chelonae strains consist of the most frequent published reports, but one of the outbreaks included Mycobacterium tuberculosis wound infections affecting 8 patients submitted to videolaparoscopic surgery in a hospital in India 16 .…”

Section: Discussionmentioning

confidence: 99%

“…The affected patients are generally healthy and the majority of infections evolutes with significant clinical signs after 4 weeks following traumatic procedures or fractures. Some cases and short outbreaks have also been related to medical or surgical procedures including needle injections, videolaparoscopy, cardiac surgery and esthetics procedures 1,2 .…”

Section: Introductionmentioning

confidence: 99%

Mycobacterium massiliense BRA100 strain recovered from postsurgical infections: resistance to high concentrations of glutaraldehyde and alternative solutions for high level disinfection

Lorena

Pitombo

Côrtes³

et al. 2010

Acta Cir. Bras.

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Purpose:To evaluate the minimum inhibitory concentration (MIC) of GTA against these microorganisms and alternative disinfectants for high-level disinfection (HLD). Methods: Reference mycobacteria and clinical M. massiliense strains were included in this study. Active cultures were submitted to susceptibility qualitative tests with GTA dilutions (ranging from 1.5% to 8%), and commercial orthophthaldehyde (OPA) and peracetic acid (PA) -based solutions, during the period of exposure as recommended by National Agency of Sanitary Surveillance for HLD. Results: All reference and M. massiliense non-BRA100 strains, recovered from sputum, were susceptible to any GTA concentration, OPA and PA solutions. M. massiliense BRA100 strains presented MIC of 8% GTA and were susceptible to OPA and PA. Conclusion: M. massiliense BRA100 strain is resistant to high GTA concentrations (up to 7%), which proves that this product is non-effective against specific rapidly growing mycobacteria and should be substituted by OPA or PA -based solutions for HLD. Key words: Mycobacterium Infections. Videolaparoscopy. Disinfection. Glutaraldehyde. RESUMOObjetivo: Avaliar a concentração mínima inibitória (CMI) de GTA frente a M. massiliense e a susceptibilidade a produtos alternativos para desinfecção de alto nível (DAN). Métodos: Cepas de M. massiliense de origem clínica e de referência foram incluídas no estudo. As culturas ativadas foram submetidas a testes qualitativos com diluições de GTA (de 1,5% a 8%) e com soluções comerciais de ortoftaldeído (OPA) ou ácido peracético (PA), utilizando os tempos de exposição recomendados pela Agência Nacional de Vigilância Sanitária para DAN. Resultados: Todas as cepas de referência e M. massiliense não-BRA100, obtida de escarro, foram susceptíveis às concentrações de GTA, e soluções de OPA e PA. As cepas de M. massiliense BRA100 apresentaram CMI de 8% para GTA e foram susceptíveis a OPA e PA. Conclusão: M. massiliense BRA100 é resistente a altas concentrações de GTA (até 7%), o que demonstra que esse composto não é eficaz, e deve ser substituído por OPA ou PA nos processos de DAN.

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Hospital outbreak of atypical mycobacterial infection of port sites after laparoscopic surgery

Cited by 86 publications

References 14 publications

Diagnosis and Management of Atypical Mycobacterial Infection after Laparoscopic Surgery

Diagnosis and Management of Atypical Mycobacterial Infection after Laparoscopic Surgery

Non Tuberculous Mycobacterium as a Causative Factor in Port Site Wound Infection - A Case Report

Mycobacterium massiliense BRA100 strain recovered from postsurgical infections: resistance to high concentrations of glutaraldehyde and alternative solutions for high level disinfection

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