Journal Article

Long-Term Laboratory Contamination by <i>Mycobacterium abscessus</i> Resulting in Two Pseudo-Outbreaks: Recognition with Use of Random Amplified Polymorphic DNA (RAPD) Polymerase Chain Reaction

Kwan Kew Lai, Barbara A. Brown, Judy A. Westerling, Sally A. Fontecchio, Yansheng Zhang and Richard J. Wallace

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 1, pages 169-175
Published in print July 1998 | ISSN: 1058-4838
Published online July 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514635
Long-Term Laboratory Contamination by Mycobacterium abscessus Resulting in Two Pseudo-Outbreaks: Recognition with Use of Random Amplified Polymorphic DNA (RAPD) Polymerase Chain Reaction

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Beginning in 1993, an increase in clinical isolates of Mycobacterium abscessus was observed in a single hospital microbiology laboratory. This involved a cluster of four patients in June 1993 and five patients and a quality-control culture of distilled water in May 1994. Twenty-three M. abscessus isolates recovered between 1991 and 1996 were compared by random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). Sixteen of 21 clinical isolates recovered over a 6-year period and the distilled water isolate had identical RAPD-PCR patterns consistent with a single strain or clone. Only six of 15 patients had findings suggestive of clinical disease. Since the use of in-house-prepared distilled water was discontinued, no further laboratory contamination of clinical specimens has been observed. Molecular typing was the key to defining distilled water as the source of this pseudo-outbreak. Recognition of such Beginning in 1993, an increase in clinical isolates of Mycobacterium abscessus was observed in a single hospital microbiology laboratory. This involved a cluster of four patients in June 1993 and five patients and a quality-control culture of distilled water in May 1994. Twenty-three M. abscessus isolates recovered between 1991 and 1996 were compared by random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). Sixteen of 21 clinical isolates recovered over a 6-year period and the distilled water isolate had identical RAPD-PCR patterns consistent with a single strain or clone. Only six of 15 patients had findings suggestive of clinical disease. Since the use of in-house-prepared distilled water was discontinued, no further laboratory contamination of clinical specimens has been observed. Molecular typing was the key to defining distilled water as the source of this pseudo-outbreak. Recognition of such outbreaks is important for prevention of unnecessary therapeutic and diagnostic interventions.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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