Investigation of an Outbreak of Rapidly-Growing Mycobacteria (RGM) Among Bone-Marrow Transplant (BMT) Unit Patients Brooke Army Medical Center (BAMC), Fort Sam Houston, Texas, June 1998.
ARMY CENTER FOR HEALTH PROMOTION AND PREVENTIVE MEDICINE (PROVISIONAL) ABERDEEN PROVING GROUND MD
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An epidemiologic consultation EPICON investigation was conducted during the month of June 1998 to examine reports of increased number of rapidly-growing mycobacteria ROM among bone marrow transplant BMT patients at Brooke Army Medical Center, San Antonio, Texas. Upon request, a team from the USACHPPM assisted the BAMC staff to identify and characterize risk factors for RGM infection and to develop intervention control plans. The initial review of cases revealed a high rate of RGM infection 10 cases in 75 patients, rate of 13.3 in BMT unit patients,during FY98 Oct 97-May 98. A case-control study was undertaken involving all 14 cases and two control groups, an internal group non-infected patients at the BMT unit, n23 and an external group non-infected patients at the Heme-onc ward, n23. Only central venous CV catheter inflammation AOR7.63, 95 CI 1.32-44.08 and a positive blood culture AOR6.38, 95 CI 1.06-38.39 during hospitalization were correlated with RGM infection risk. Mycobacterial culture and pulse-field gel electrophoresis PFGE DNA typing revealed several patient isolates similar to water sample isolates recovered simultaneously from the BAMC potable water system. Recommendations for control of contamination of the BAMC water system were made and efforts to control this problem are ongoing.
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