Pseudooutbreak of rapidly growing mycobacteria due to Mycobacterium abscessus subsp bolletii in a digestive and respiratory endoscopy unit caused by the same clone as that of a countrywide outbreak

Guimarães, Thaís; Chimara, Érica; Prado, Gladys Villas Boas do; Ferrazoli, Lucilaine; Carvalho, Natália Fernandes Garcia de; Simeão, Fernanda Cristina dos Santos; Souza, Andreia Rodrigues de; Costa, Christiane A.R.; Niero, Cristina Viana; Brianesi, Urze Adomaitis; Gioia, Thais Romano Di; Gomes, Laura Maria Brasileiro; Spadão, Fernanda; Silva, Maria das Graças; Moura, Eduardo Guimarães Hourneaux de; Levin, Anna S.

doi:10.1016/j.ajic.2016.06.019

Cited by 34 publications

(23 citation statements)

References 19 publications

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“…The MSTs also highlight the lineage’s ability to persist in the hospital environment [ 14 ], as the outbreak in Pará occurred from 2004–2005 but transmission events continued to emanate from Pará until 2010. This implies that the lineage has adapted to survive within the hospital environment and suggests that there is the potential for further outbreaks to occur if poor practices were to re-emerge [ 10 ]. The combination of the ability to persist in the hospital environment and undergo long-distance spread has serious implications for the global spread of M. a. massiliense lineages.…”

Section: Discussionmentioning

confidence: 99%

“…The outbreak lineage was not solely isolated from post-surgical wound infections, with isolates matching the outbreak PFGE pattern collected from sputum and urine specimens and samples from endoscopes. Some of these isolates were sampled from locations where outbreaks of skin and soft tissue infections had not occurred [ 10, 17 ]. This led to speculation that the cause of the outbreaks could be a Brazilian environmental lineage as opposed to a recently introduced lineage that had subsequently adapted to the surgical niche and spread either via surgeons or contaminated disinfectants.…”

Section: Introductionmentioning

confidence: 99%

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Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil

et al. 2017

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An epidemic of post-surgical wound infections, caused by a non-tuberculous mycobacterium, has been on-going in Brazil. It has been unclear whether one or multiple lineages are responsible and whether their wide geographical distribution across Brazil is due to spread from a single point source or is the result of human-mediated transmission. 188 isolates, collected from nine Brazilian states, were whole genome sequenced and analysed using phylogenetic and comparative genomic approaches. The isolates from Brazil formed a single clade, which was estimated to have emerged in 2003. We observed temporal and geographic structure within the lineage that enabled us to infer the movement of sub-lineages across Brazil. The genome size of the Brazilian lineage was reduced relative to most strains in the three subspecies of Mycobacterium abscessus and contained a novel plasmid, pMAB02, in addition to the previously described pMAB01 plasmid. One lineage, which emerged just prior to the initial outbreak, is responsible for the epidemic of post-surgical wound infections in Brazil. Phylogenetic analysis indicates that multiple transmission events led to its spread. The presence of a novel plasmid and the reduced genome size suggest that the lineage has undergone adaptation to the surgical niche.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil

et al. 2017

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“…Poor disinfection and resistance to glutaraldehydes have been highlighted in pseudo-outbreaks of M. abscessus subsp. bolletii in bronchoscopes, endoscopes, and disinfection units (Guimaraes et al, 2016). In other areas of the hospital, patient accessible ice machines have been shown to be laden with NTM, particularly M. paraffinicum and M. fortuitum (Gebo et al, 2002; Wang et al, 2009).…”

Section: Typical Environmental Habitats Of Ntmmentioning

confidence: 99%

Global Environmental Nontuberculous Mycobacteria and Their Contemporaneous Man-Made and Natural Niches

2018

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Seminal microbiological work of environmental nontuberculous mycobacteria (NTM) includes the discovery that NTM inhabit water distribution systems and soil, and that the species of NTM found are geographically diverse. It is likely that patients acquire their infections from repeated exposures to their environments, based on the well-accepted paradigm that water and soil bioaerosols – enriched for NTM – can be inhaled into the lungs. Support comes from reports demonstrating NTM isolated from the lungs of patients are genetically identical to NTM found in their environment. Well documented sources of NTM include peat-rich soils, natural waters, drinking water, hot water heaters, refrigerator taps, catheters, and environmental amoeba. However, NTM have also been recovered in biofilms from ice machines, heated nebulizers, and heater-cooler units, as well as seat dust from theaters, vacuum cleaners, and cobwebs. New studies on the horizon aim to significantly expand the current knowledge of environmental NTM niches in order to improve our current understanding of the specific ecological factors driving the emergence of NTM lung disease. Specifically, the Hawaiian Island environment is currently being studied as a model to identify other point sources of exposure as it is the U.S. state with the highest number of NTM lung disease cases. Because of its geographic isolation and unique ecosystem, the Hawaiian environment is being probed for correlative factors that may promote environmental NTM colonization.

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“…M. abscessus is an emerging pathogen usually associated with chronic pulmonary infections in cystic fibrosis patients. 2 , 4 , 6 , 11 The second most frequent infection sites are the skin and the subcutaneous tissue. Most of the cutaneous infections described in the literature occur secondary to a cosmetic procedure.…”

Section: Discussionmentioning

confidence: 99%

Mycobacterium abscessus Infection after Breast Lipotransfer: A Report of 2 Cases

Escuredo

Elorduy

Carrión

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Summary: Mycobacterium abscessus is a rare, non-tuberculous, rapidly growing mycobacterium. Although it has been usually associated with chronic pulmonary infections in cystic fibrosis patients, the second most frequent infection sites are the skin and subcutaneous tissue. Most of the cutaneous infections described in the literature occur secondary to cosmetic invasive procedures, many of them in the context of medical tourism. Its atypical presentation and antibiotic-resistant nature make its diagnosis and therapeutics challenging. In this case report, we present 2 cases of M. abscessus infections secondary to breast lipotransfer reported in the same private center. Case 1 patient underwent surgery to treat scar contracture resulting from previous quadrantectomy. Case 2 patient underwent breast augmentation with lipotransfer. Both of them developed lesions in the breast and in the donor site (abdomen). The therapeutic regimen used was amikacin (1 g/24 h) + tigecycline (50 mg/12 h). In case 1, we performed a simple mastectomy, and in case 2, periodical ultrasound-guided drainages were performed as additional procedures. To our knowledge, these are the first 2 cases that describe an infection secondary to breast lipotransfer. The aim of our report was to illustrate the presentation, diagnosis, therapeutic management, and strategies available to prevent this complication.

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Pseudooutbreak of rapidly growing mycobacteria due to Mycobacterium abscessus subsp bolletii in a digestive and respiratory endoscopy unit caused by the same clone as that of a countrywide outbreak

Cited by 34 publications

References 19 publications

Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil

Genomic epidemiology of a national outbreak of post-surgical Mycobacterium abscessus wound infections in Brazil

Global Environmental Nontuberculous Mycobacteria and Their Contemporaneous Man-Made and Natural Niches

Mycobacterium abscessus Infection after Breast Lipotransfer: A Report of 2 Cases

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