Background: Healthcare-associated acquisition and transmission of nontuberculous mycobacteria (NTM) among people with cystic fibrosis (pwCF) has been described, and remains a concern for both patients and providers. This report describes the design of a prospective observational study utilizing the standardized epidemiologic investigation toolkit for healthcare-associated links in transmission of NTM among pwCF.
Methods: This is a parallel multi-site study of pwCF who have infections with respiratory NTM isolates and receive healthcare within a common CF Care Center. Participants have a history of one or more NTM positive airway cultures and have been identified as having NTM infections suggestive of a possible outbreak within a single Center, based on NTM isolate genomic analysis. Participants are enrolled in the study over a 3-year period. Primary endpoints are identification of shared healthcare-associated source(s) among pwCF in a Center, identification of healthcare environmental dust and water biofilm NTM isolates that are genetically highly-related to respiratory isolates, and identification of common home of residence watersheds among pwCF infected with clustered isolates. Secondary endpoints include characterization of healthcare-associated transmission and/or acquisition modes and settings as well as description of incidence and prevalence of healthcare-associated environmental NTM species/subspecies by geographical region.
Discussion: We hypothesize that genetically highly-related isolates of NTM among pwCF cared for at the same Center may arise from healthcare sources including patient-to-patient transmission and/or acquisition from health-care environmental dust and/or water biofilms. This study design utilizes a published, standardized, evidence-based epidemiologic toolkit to facilitate confidential, independent healthcare-associated NTM outbreak investigations within CF Care Centers. This study will facilitate real-time, rapid detection and mitigation of healthcare-associated NTM outbreaks to reduce NTM risk, inform infection prevention and control guidelines, and characterize the prevalence and origin of NTM outbreaks from healthcare-associated patient-to-patient transmission and/or environmental acquisition. This study will systematically characterize human disease causing NTM isolates from serial collection of healthcare environmental dust and water biofilms and define the most common healthcare environmental sources harboring NTM biofilms.
Trial Registration: ClinicalTrials.gov NCT05686837.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10732400 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0291910 | PLOS |
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Medical Emergency Unit, Unidade Local de Saúde de São José, Lisbon, PRT.
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January 2025
Department of Urban Engineering, School of Engineering, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-8656, Japan; Research Center for Advanced Science and Technology, The University of Tokyo, 4-6-1, Komaba, Meguro, Tokyo 153-8904, Japan. Electronic address:
The health burden of waterborne nontuberculous mycobacteria (NTM) is a rising concern. While the water supply systems can serve as a potential reservoir for NTM, their abundance, diversity, and transmission pathways remain unknown. This study aimed to characterize the prevalence and regrowth of NTM in building water supply system in a hospital where many M.
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December 2024
Department of Laboratory Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea.
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Rev Med Chil
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Laboratorio Biología Molecular, Hospital Base de Valdivia, Valdivia, Chile.
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Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, THA.
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