Hospital water as a source of Mycobacterium avium complex isolates in respiratory specimens. 2004

Melissa J Tobin-D'Angelo, and Mitchell A Blass, and Carlos del Rio, and J Sue Halvosa, and Henry M Blumberg, and C Robert Horsburgh
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.

The clinical significance of recovery of Mycobacterium avium complex (MAC) organisms from respiratory specimens is poorly understood. One hundred sixty-one respiratory MAC isolates from 131 patients at Grady Memorial Hospital (Atlanta) and 13 MAC isolates from the hospital's hot water system were examined. Of the 131 patients, 35 (27%) had MAC disease, and 96 (73%) did not; 94 (72%) were human immunodeficiency virus infected. Ten different clusters were identified by pulsed-field gel electrophoresis. Patients without MAC disease were significantly more likely to have clustered isolates than were patients with MAC disease. Of 110 MAC isolates recovered from patients without MAC disease, 72 (65%) were part of a single large cluster that contained isolates recovered from the hospital's hot water system; 13 (25%) of 51 isolates from patients with MAC disease were also in this cluster. We conclude that acquisition of MAC from institutional water systems leads to substantial MAC disease but that most patients with MAC recovered from respiratory specimens have only transient colonization by MAC.

UI MeSH Term Description Entries
D012141 Respiratory Tract Infections Invasion of the host RESPIRATORY SYSTEM by microorganisms, usually leading to pathological processes or diseases. Respiratory System Infections,Upper Respiratory Tract Infection,Upper Respiratory Tract Infections,Infections, Respiratory,Infections, Respiratory Tract,Infections, Upper Respiratory,Infections, Upper Respiratory Tract,Respiratory Infections,Upper Respiratory Infections,Infection, Respiratory System,Infection, Respiratory Tract,Respiratory Infection, Upper,Respiratory System Infection,Respiratory Tract Infection
D002353 Carrier State The condition of harboring an infective organism without manifesting symptoms of infection. The organism must be readily transmissible to another susceptible host. Asymptomatic Carrier State,Asymptomatic Infection Carrier,Inapparent Infection Carrier,Presymptomatic Carrier State,Presymptomatic Infection Carrier,Super-spreader Carrier,Superspreader Carrier,Asymptomatic Carrier States,Asymptomatic Infection Carriers,Carrier State, Asymptomatic,Carrier State, Presymptomatic,Carrier States,Carrier, Super-spreader,Carrier, Superspreader,Carriers, Super-spreader,Carriers, Superspreader,Inapparent Infection Carriers,Infection Carrier, Asymptomatic,Infection Carrier, Inapparent,Infection Carrier, Presymptomatic,Presymptomatic Carrier States,Presymptomatic Infection Carriers,Super spreader Carrier,Super-spreader Carriers,Superspreader Carriers
D003428 Cross Infection Any infection which a patient contracts in a health-care institution. Hospital Infections,Nosocomial Infections,Health Care Associated Infection,Health Care Associated Infections,Healthcare Associated Infections,Infection, Cross,Infections, Hospital,Infections, Nosocomial,Cross Infections,Healthcare Associated Infection,Hospital Infection,Infection, Healthcare Associated,Infection, Hospital,Infection, Nosocomial,Infections, Cross,Infections, Healthcare Associated,Nosocomial Infection
D005845 Georgia A state located in the southeastern United States, The capital is Atlanta.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013183 Sputum Material coughed up from the lungs and expectorated via the mouth. It contains MUCUS, cellular debris, and microorganisms. It may also contain blood or pus. Sputum, Induced,Induced Sputum,Induced Sputums,Sputums,Sputums, Induced
D014871 Water Microbiology The presence of bacteria, viruses, and fungi in water. This term is not restricted to pathogenic organisms. Microbiology, Water
D014881 Water Supply Means or process of supplying water (as for a community) usually including reservoirs, tunnels, and pipelines and often the watershed from which the water is ultimately drawn. (Webster, 3d ed) Supplies, Water,Supply, Water,Water Supplies
D015269 Mycobacterium avium Complex A complex that includes several strains of M. avium. M. intracellulare is not easily distinguished from M. avium and therefore is included in the complex. These organisms are most frequently found in pulmonary secretions from persons with a tuberculous-like mycobacteriosis. Strains of this complex have also been associated with childhood lymphadenitis and AIDS; M. avium alone causes tuberculosis in a variety of birds and other animals, including pigs. Battey Bacillus,MAIC,Mycobacterium avium-intracellulare,Mycobacterium avium-intracellulare Complex,Mycobacterium intracellulare,Nocardia intracellularis
D015270 Mycobacterium avium-intracellulare Infection A nontuberculous infection when occurring in humans. It is characterized by pulmonary disease, lymphadenitis in children, and systemic disease in AIDS patients. Mycobacterium avium-intracellulare infection of birds and swine results in tuberculosis. Mycobacterium intracellulare Infection,Infection, Mycobacterium avium-intracellulare,Infection, Mycobacterium intracellulare,Mycobacterium avium intracellulare Infection,Infection, Mycobacterium avium intracellulare,Infections, Mycobacterium avium-intracellulare,Infections, Mycobacterium intracellulare,Mycobacterium avium-intracellulare Infections,Mycobacterium intracellulare Infections

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