Article

Five-year outbreak of community- and hospital-acquired Mycobacterium porcinum infections related to public water supplies.

The University of Texas Health Science Center at Tyler, Department of Microbiology, 11937 US Hwy 271, Tyler, TX 75708, USA.
Journal of clinical microbiology (impact factor: 4.16). 12/2011; 49(12):4231-8. DOI:10.1128/JCM.05122-11 pp.4231-8
Source: PubMed

ABSTRACT Mycobacterium porcinum is a rarely encountered rapidly growing Mycobacterium (RGM). We identified M. porcinum from 24 patients at a Galveston university hospital (University of Texas Medical Branch) over a 5-year period. M. porcinum was considered a pathogen in 11 (46%) of 24 infected patients, including 4 patients with community-acquired disease. Retrospective patient data were collected, and water samples were cultured. Molecular analysis of water isolates, clustered clinical isolates, and 15 unrelated control strains of M. porcinum was performed. Among samples of hospital ice and tap water, 63% were positive for RGM, 50% of which were M. porcinum. Among samples of water from the city of Galveston, four of five households (80%) were positive for M. porcinum. By pulsed-field gel electrophoresis (PFGE), 8 of 10 environmental M. porcinum were determined to belong to two closely related clones. A total of 26 of 29 clinical isolates subjected to PFGE (including isolates from all positive patients) were clonal with the water patterns, including patients with community-acquired disease. Fifteen control strains of M. porcinum had unique profiles. Sequencing of hsp65, recA, and rpoB revealed the PFGE outbreak clones to have identical sequences, while unrelated strains exhibited multiple sequence variants. M. porcinum from 22 (92%) of 24 patients were clonal, matched hospital- and household water-acquired isolates, and differed from epidemiologically unrelated strains. M. porcinum can be a drinking water contaminant, serve as a long-term reservoir (years) for patient contamination (especially sputum), and be a source of clinical disease. This study expands concern about public health issues regarding nontuberculous mycobacteria. Multilocus gene sequencing helped define clonal populations.

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Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

10 environmental M. porcinum
 
5-year period
 
define clonal populations
 
drinking water contaminant
 
epidemiologically unrelated strains
 
Galveston university hospital
 
long-term reservoir
 
M. porcinum
 
Molecular analysis
 
Multilocus gene sequencing
 
Mycobacterium porcinum
 
nontuberculous mycobacteria
 
patient contamination
 
pulsed-field gel electrophoresis
 
Retrospective patient data
 
study expands concern
 
tap water
 
Texas Medical Branch
 
water patterns
 
water samples
 

Barbara A Brown-Elliott