Skip Navigation LinksHome > March 2014 - Volume 33 - Issue 3 > An Outbreak of Mycobacterium abscessus Infection in a Pediat...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0000000000000071
Original Studies

An Outbreak of Mycobacterium abscessus Infection in a Pediatric Intensive Care Unit in Kuwait

Jamal, Wafaa MD, PhD, FRCPath*†‡; Salama, Mona F. MD, PhD‡§; Al Hashem, G. MD, FRCPath; Rifaei, M. MD; Eldeen, H. MD; Husain, Entesar H. MD, FRCP(C); Ahmad, S. PhD*; Rotimi, Vincent O. MD, PhD, FRCPath*†‡

Collapse Box


Background: Mycobacterium abscessus has been associated with respiratory tract infections, localized skin and soft tissue infections and sepsis. However, outbreaks of M. abscessus are rare.

Aim: to report an outbreak of M. abscessus causing respiratory tract infections in a Pediatric Intensive Care Unit (PICU) in Kuwait, its investigation and control measures.

Methods: Respiratory secretions were obtained from ventilator-dependent patients showing signs of sepsis, including fever, malaise and weight loss. The specimens were cultured on appropriate routine media. After the results of the sample taken from the index case as acid-fast bacilli positive, all patients were screened for M. abscessus carriage. Isolates were identified by INNO-LiPA Mycobacteria v2 line probe assay and DNA sequencing. Molecular fingerprinting DiversiLab strain typing was performed on the isolates. Epidemiologic investigation was conducted during the outbreak.

Findings: the outbreak affected 5 patients, 4 of whom had severe infections including 1 patient with septicemia. Asymptomatic carriage of outbreak strain was found in 1 patient. All environmental samples were negative for M. abscessus but some were positive for M. gordonae and M. fortuitum. The source could not be identified. Stringent infection control measures were put in place, including reemphasizing hand hygiene and closure of the Pediatric Intensive Care Unit to new admissions. A year later, no further case has occurred after the last case.

Conclusion: To our knowledge, this is the first report of a hospital-acquired outbreak of respiratory tract infection caused by M. abscessus in a Pediatric Intensive Care Unit. In the absence of definite source identification, reinforcement of standard infection control guidelines was successful in containing the outbreak.

© 2014 by Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.