Investigation of two cases of Mycobacterium chelonae infection in haemato-oncology patients using whole genome sequencing and a potential link to the hospital water supply

T. Inkster, C. Peters, A.L. Seagar, M.T.G. Holden, I.F. Laurenson

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Abstract

Background

Haemato-oncology patients are at increased risk of infection from atypical mycobacteria such as Mycobacterium chelonae which are commonly found in both domestic and hospital water systems.

Aims

To describe the investigation and control measures following two patient cases of M. chelonae and positive water samples in our hospital.

Methods

Water testing was undertaken from outlets, storage tanks and mains supply. We utilised whole genome sequencing (WGS) to compare patient and positive water samples. We describe the subsequent infection control measures implemented.

Findings

The WGS results showed two main populations of M. chelonae within the group of sampled isolates. The results showed that the patient strains were unrelated to each other but that the isolate from one patient was closely related to environmental samples from water outlets, supporting nosocomial acquisition.

Conclusions

We describe the utility of WGS in the investigation of two patient cases of M. chelonae, and positive water samples from a hospital water supply. We discuss relevant control measures and the potential for chemical dosing of water systems to enhance proliferation of atypical mycobacteria.

Original languageEnglish
JournalJournal of Hospital Infection
VolumeIn Press
Early online date1 May 2021
DOIs
Publication statusE-pub ahead of print - 1 May 2021

Keywords

  • Water
  • Immunosuppression
  • Whole Genome Sequencing
  • Mycobacterium chelonae

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