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

doi:10.1016/j.jhin.2021.04.028

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

Research output: Contribution to journal › Article › peer-review

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 language	English
Journal	Journal of Hospital Infection
Volume	In Press
Early online date	1 May 2021
DOIs	https://doi.org/10.1016/j.jhin.2021.04.028
Publication status	E-pub ahead of print - 1 May 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Water
Immunosuppression
Whole Genome Sequencing
Mycobacterium chelonae

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10.1016/j.jhin.2021.04.028

Inkster-2021-Investigation-of-two-cases-JHI-AAM
Crown Copyright © 2021 Published by Elsevier Ltd on behalf of The Healthcare Infection Society. All rights reserved.. This work has been made available online in accordance with publisher policies or with permission. Permission for further reuse of this content should be sought from the publisher or the rights holder. This is the author created accepted manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at https://doi.org/10.1016/j.jhin.2021.04.028.
Accepted author manuscript, 286 KBLicence: CC BY-NC-ND

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@article{43f684de2bff405cb589dac353694e72,

title = "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",

abstract = "BackgroundHaemato-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.AimsTo describe the investigation and control measures following two patient cases of M. chelonae and positive water samples in our hospital.MethodsWater 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.FindingsThe 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.ConclusionsWe 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.",

keywords = "Water, Immunosuppression, Whole Genome Sequencing, Mycobacterium chelonae",

author = "T. Inkster and C. Peters and A.L. Seagar and M.T.G. Holden and I.F. Laurenson",

year = "2021",

month = may,

day = "1",

doi = "10.1016/j.jhin.2021.04.028",

language = "English",

volume = "In Press",

journal = "Journal of Hospital Infection",

issn = "0195-6701",

publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - 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

AU - Inkster, T.

AU - Peters, C.

AU - Seagar, A.L.

AU - Holden, M.T.G.

AU - Laurenson, I.F.

PY - 2021/5/1

Y1 - 2021/5/1

N2 - BackgroundHaemato-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.AimsTo describe the investigation and control measures following two patient cases of M. chelonae and positive water samples in our hospital.MethodsWater 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.FindingsThe 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.ConclusionsWe 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.

AB - BackgroundHaemato-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.AimsTo describe the investigation and control measures following two patient cases of M. chelonae and positive water samples in our hospital.MethodsWater 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.FindingsThe 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.ConclusionsWe 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.

KW - Water

KW - Immunosuppression

KW - Whole Genome Sequencing

KW - Mycobacterium chelonae

U2 - 10.1016/j.jhin.2021.04.028

DO - 10.1016/j.jhin.2021.04.028

M3 - Article

SN - 0195-6701

VL - In Press

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

ER -

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

Abstract

UN SDGs

Keywords

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