Artigo mostra caminhos assumidos em investigação de nexo causal de infecção por Mycobatérias em Hospital nos EUA.
Investigation of a Cluster of Rapidly Growing Mycobacteria Infections Associated with Joint Replacement Surgery in a Kentucky Hospital, 2013–2014 With 8-Year Follow-Up
Study authors: Matthew R. Groenewold, NIOSH; Andrea Flinchum, Aravind Pillai, and Stacey Konkle, Kentucky Department for Public Health; Heather Moulton-Meissner, CDC; Pritish K. Tosh, MD, Mayo Clinic; and Douglas A. Thoroughman, NIOSH, Kentucky Department for Public Health
Why is this study important?
Healthcare-associated infections from rapidly growing mycobacteria, or RGM, pose a serious risk to patients undergoing joint replacement surgery. These hardy bacteria can withstand extreme temperatures and lack of nutrients. They are present throughout the environment, including soil, water, and contaminated hospital settings. Finding and eliminating risk factors for these bacteria in hospitals is critical.
How did you do the study?
We investigated potential routes of exposure after a Kentucky hospital reported five cases of RGM infections occurring January–September 2013. We compared the five patients with infections with 20 randomly selected patients. All patients had received joint replacement surgery between October 2012 and March 2013. In addition, we evaluated the hospital’s efforts to prevent repeated RGM infections for eight years after the outbreak.
What did you find?
Overall, we found eight infections caused by two types of RGM. Five of the infections were caused by M. wolinskyi and three by M. goodii. Although we did not find a source of the infections in the hospital environment itself, a common factor was one nurse who worked in the operating room. The nurse had no symptoms but reported using an outdoor hot tub at home. We sampled the water, found that the bacteria M. wolinskyi was present. We confirmed these results with genetic sequencing and other specialized testing. As a result, the hot tub was removed from use, eliminating it as a source of RGM infections. The hospital revised its policies to prevent future infections. As of 2021, we have found no new RGM infections in the hospital.
What are the next steps?
Our findings highlight the importance of considering healthcare workers as a source of RGM transmission among joint-replacement recipients. Furthermore, they show the importance of carefully following all recommendations to prevent RGM and other infections in hospitals.
O artigo completo de livre acesso está disponível em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896514/ ou https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9896514/pdf/nihms-1864254…