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Rapidly Growing Mycobacteria among Pediatric Hematopoietic Cell Transplant Patients Traced to the Hospital Water Supply

Iroh Tam, Pui-Ying MD*; Kline, Susan MD, MPH; Wagner, John E MD; Guspiel, Amanda MPH§; Streifel, Andrew MPH, REHS; Ward, Ginger RN§; Messinger, Keith CHFM§; Ferrieri, Patricia MD*‖

The Pediatric Infectious Disease Journal: October 2014 - Volume 33 - Issue 10 - p 1043–1046
doi: 10.1097/INF.0000000000000391
Original Studies
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Background: Rapidly growing mycobacteria (RGM) have a predilection for those with immunocompromised states. We report increased isolation of RGM among pediatric hematopoietic cell transplant patients that was traced to the hospital water supply.

Methods: Cases of RGM-positive patients were differentiated based on whether they were community-acquired or nosocomial, colonized or infected based on predefined criteria. Medical records of all RGM-positive patients were reviewed and data extracted. Infection control outbreak measures were instituted and an environmental investigation was conducted.

Results: Between July 2011 and April 2012, 16 RGM isolates were identified among 15 hematopoietic cell transplant patients, compared with none in the preceding year. After environmental samples were initially grown on media for heterotrophic counts and further speciated, RGM species were identified in the hospital water supply.

Conclusions: This outbreak of RGM was traced to an environmental source and was successfully controlled through institution of infection control measures.

From the *Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology, University of Minnesota Amplatz Children’s Hospital; Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota; Department of Pediatrics, Division of Pediatric Blood and Marrow Transplantation, University of Minnesota Amplatz Children’s Hospital; §University of Minnesota Medical Center, Fairview and University of Minnesota Amplatz Children’s Hospital, Minneapolis, MN, USA; Department of Environmental Health; and Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.

Accepted for publication April 21, 2014.

This data was presented at ID Week in San Francisco, CA in October 2013, and at the Association for Professionals in Infection Control and Epidemiology conference in Fort Lauderdale, FL in June 2013.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Pui-Ying Iroh Tam, MD, 3–210 MTRF, 2001 6th St SE, Minneapolis, MN 55455.E-mail: irohtam@umn.edu.

© 2014 by Lippincott Williams & Wilkins, Inc.