某医院内石蜡分支杆菌假暴发感染调查（翻译有奖）
本帖最后由 潮水 于 2010-4-21 20:33 编辑Infect Control Hosp Epidemiol 2009;30:848–853
© 2009 by The Society for Healthcare Epidemiology of America. All rights reserved.
0899-823X/2009/3009-0005$15.00
DOI: 10.1086/599071
Original Article
Pseudo‐Outbreak of “Mycobacterium paraffinicum” Infection and/or Colonization in a Tertiary Care Medical Center
某医院内石蜡分支杆菌假暴发感染调查
Shu‐Hua Wang, MD, MPH&TM;
Preeti Pancholi, PhD;
Kurt Stevenson, MD, MPH;
Mitchell A. Yakrus, MS, MPH;
W. Ray Butler, MS;
Larry S. Schlesinger, MD;
Julie E. Mangino, MD
From the Center for Microbial Interface Biology, Division of Infectious Diseases, Department of Internal Medicine (S.‐H.W., K.S., L.S.S., J.E.M.), and the Division of Clinical Microbiology, Department of Pathology (P.P.), The Ohio State University Medical Center, Columbus, Ohio; and the Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Atlanta, Georgia (W.R.B., M.A.K.).
Objective.To investigate a pseudo‐outbreak of “Mycobacterium paraffinicum” (unofficial taxon) infection and/or colonization, using isolates recovered from clinical and environmental specimens.
Design.Outbreak investigation.
Setting.University‐affiliated, tertiary‐care hospital.
Methods.M. paraffinicum, a slow‐growing, nontuberculous species of mycobacteria, was recovered from 21 patients and an ice machine on a single patient care unit over a 2.5‐year period. The clinical, epidemiological, and environmental investigation of this pseudo‐outbreak is described.
Results.Twenty‐one patients with pulmonary symptoms and possible risk factors for tuberculosis were admitted to inpatient rooms that provided airborne isolation conditions in 2 adjacent hospital buildings. In addition, 1 outpatient had induced sputum cultured for mycobacteria in the pulmonary function laboratory. Of the samples obtained from these 21 patients, 26 isolates from respiratory samples and 1 isolate from a stool sample were identified as M. paraffinicum. Environmental isolates obtained from an ice machine in the patient care unit where the majority of the patients were admitted were also identified as M. paraffinicum.
Conclusions.An epidemiological investigation that used molecular tools confirmed the suspicion of a pseudo‐outbreak of M. paraffinicum infection and/or colonization. The hospital water system was identified as the source of contamination.
本文用分子流行病学的方法，调查分析了一所医院石蜡分支杆菌假爆发来源于医院得水系统受污染所致。是一篇较严谨的有关医院感染爆发的流调文献。 目的：为调查石蜡分支杆菌假爆发感染和/或定植，利用从临床和环境中标本的分离中发现细菌。
设计：爆发调查
场所 大学附属医院，三级医院
方法：石蜡分支杆菌是一种生长缓慢，非结核性的分支杆菌属，在21例病人和单独病人护理单元中一台使用超过2.5年制冰机中发现这种细菌。描述了对这种假性爆发临床、流行病学和环境调查。
结果：21例有肺部症状和可能有结核风险因素的病人，收入病房，在2个邻近的医院建筑中提供空气接触隔离。另外，1个出院病人在肺功能实验室进行查找分支杆菌的痰培养。所有的标本来自这21个病人，从呼吸道样品中有26个分离出石蜡分支杆菌细菌，1个来自粪便标本也发现有石蜡分支杆菌。从病人护理单元中的制冰机得到环境细菌分离，在大部分住在那里的病人也发现石蜡分支杆菌。
结论：用分子生物学工具进行流行病学调查，确信了石蜡分支杆菌假爆发和/或定植的怀疑。医院水系统被认为是污染源。
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