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September 16, 1988, Vol 260, No. 11 >
ARTICLE | September 16, 1988

Concentration of Mycobacterium avium by Hospital Hot Water Systems FREE

Gary C. du Moulin, PhD, MPH; Kurt D. Stottmeier, PhD; Pierre A. Pelletier; Anna Y. Tsang, MS; John Hedley-Whyte, MD
[+] Author Affiliations

Reprint requests to DA-717, Department of Anaesthesia, Beth Israel Hospital, 330 Brookline, MA 02215 (Dr du Moulin).


JAMA. 1988;260(11):1599-1601. doi:10.1001/jama.1988.03410110107037
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References

Water from 34 sites on two temporarily vacant hospital floors was analyzed for the presence of mycobacteria. These sites included 18 cold water taps and 16 hot water taps, including shower heads. A total of 14 sites (41%) demonstrated the presence of Mycobacterium avium as confirmed by biochemical characterization, DNA/rRNA probe analysis, and seroagglutination. Of positive sites, 11 were hot water sources with an average temperature of 55°C and yielding up to 500 colony-forming units per 100 mL. Seven of 11 strains analyzed for glycolipid antigens were identified with the type 4 serovar, the preponderant serovar of M avium in patients with acquired immunodeficiency syndrome from the Boston area. Potable hot water systems, particularly those that generate aerosols, may contain concentrations of M avium greater than those found in cold water systems and could serve as an environmental source for colonization and infection of immunocompromised persons.

(JAMA 1988;260:1599-1601)

REFERENCES

1 +
Horsburgh CR, Cohn DL, Roberts RB, et al:  Mycobacterium avium-M. intracellulare isolates from patients with or without acquired immunodeficiency syndrome . Antimicrob Agents Chemother 1986;;30:955-957.
2 +
Zakowski P, Fligel S, Berlin OG, et al:  Disseminated Mycobacterium avium-intracellulare infection in homosexual men dying of acquired immunodeficiency . JAMA 1982;;248:2980-2982.
3 +
du Moulin GC, Sherman IH, Hoaglin DC, et al:  Mycobacterium avium complex, an emerging pathogen in Massachusetts . J Clin Microbiol 1985;;22:9-12.
4 +
du Moulin GC, Coleman EC, Tsang AY, et al:  Contamination of drinking water supplies with Mycobacterium avium complex (MAC) , abstract 1101. Abstracts of the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, 1986 .
5 +
du Moulin GC, Stottmeier KD:  Use of cetylpyridinium chloride in the decontamination of water for culture of mycobacteria . Appl Environ Microbiol 1978;;36:771-773.
6 +
Tsang AY, Drupa I, Goldberg M, et al:  Use of serology and thin-layer chromatography for the assembly of an authenticated collection of serovars within the Mycobacterium avium-Mycobacterium intracellulare-Mycobacterium scrofulaceum complex . Int J Syst Bacteriol 1983;;33:285-292.
7 +
Arnow PM, Weil 0, Para MF:  Prevalence and significance of Legionella pneumophila contamination of residential hot-tap water systems . J Infect Dis 1985;;152:145-151.
8 +
Best M, Yu VL, Stout J, et al:  Legionellaceae in the hospital water supply . Lancet 1983;;2:307-310.
9 +
Hanrahan JP, Morse DL, Scharf VB, et al:  A community hospital outbreak of legionellosis: Transmission by potable hot water . Am J Epidemiol 1987;;125:639-649.
10 +
Costrini AM, Mahler DA, Gross WM, et al:  Clinical and roentgenographic features of nosocomial pulmonary disease due to Mycobacterium xenopi . Am Rev Respir Dis 1981;;123:104-109.
11 +
McSwiggan DA, Collins CH:  The isolation of M. kansasii and M. xenopi from water systems . Tubercle 1974;;55:291-297.
12 +
Masur H, Tuazon C, Gill V, et al:  Concise communications: Effect of combined clofazimine and ansamycin therapy on Mycobacterium avium-Mycobacterium intracellulare bacteremia in patients with AIDS . J Infest Dis 1987;;155:127-129.
13 +
du Moulin GC, Stottmeier KD:  Waterborne mycobacteria: An increasing threat to health . ASM News 1986;;52:525-529.
14 +
Stine TM, Harris AA, Levin S, et al:  A pseudoepidemic due to atypical mycobacteria in a hospital water supply . JAMA 1987;;258:809-811.
15 +
De Girolami PC, Tsang AY, du Moulin GC, et al:  Serovars of Mycobacterium avium complex isolated from patients with AIDS , abstract Q21. Abstracts of the 87th Annual Meeting of the American Society for Microbiology, Atlanta, 1987 .
16 +
Pelletier PA, du Moulin GC, Stottmeier KD:  Mycobacteria in public water supplies: Comparative resistance to chlorine . Microbiol Sci 1988;; 5:147-148.
17 +
O'Brien RJ, Geiter LJ, Snider DE:  The epidemiology of nontuberculous mycobacterial diseases in the United States . Am Rev Respir Dis 1987;;135:1007-1014.

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1 +
Horsburgh CR, Cohn DL, Roberts RB, et al:  Mycobacterium avium-M. intracellulare isolates from patients with or without acquired immunodeficiency syndrome . Antimicrob Agents Chemother 1986;;30:955-957.
2 +
Zakowski P, Fligel S, Berlin OG, et al:  Disseminated Mycobacterium avium-intracellulare infection in homosexual men dying of acquired immunodeficiency . JAMA 1982;;248:2980-2982.
3 +
du Moulin GC, Sherman IH, Hoaglin DC, et al:  Mycobacterium avium complex, an emerging pathogen in Massachusetts . J Clin Microbiol 1985;;22:9-12.
4 +
du Moulin GC, Coleman EC, Tsang AY, et al:  Contamination of drinking water supplies with Mycobacterium avium complex (MAC) , abstract 1101. Abstracts of the 26th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, 1986 .
5 +
du Moulin GC, Stottmeier KD:  Use of cetylpyridinium chloride in the decontamination of water for culture of mycobacteria . Appl Environ Microbiol 1978;;36:771-773.
6 +
Tsang AY, Drupa I, Goldberg M, et al:  Use of serology and thin-layer chromatography for the assembly of an authenticated collection of serovars within the Mycobacterium avium-Mycobacterium intracellulare-Mycobacterium scrofulaceum complex . Int J Syst Bacteriol 1983;;33:285-292.
7 +
Arnow PM, Weil 0, Para MF:  Prevalence and significance of Legionella pneumophila contamination of residential hot-tap water systems . J Infect Dis 1985;;152:145-151.
8 +
Best M, Yu VL, Stout J, et al:  Legionellaceae in the hospital water supply . Lancet 1983;;2:307-310.
9 +
Hanrahan JP, Morse DL, Scharf VB, et al:  A community hospital outbreak of legionellosis: Transmission by potable hot water . Am J Epidemiol 1987;;125:639-649.
10 +
Costrini AM, Mahler DA, Gross WM, et al:  Clinical and roentgenographic features of nosocomial pulmonary disease due to Mycobacterium xenopi . Am Rev Respir Dis 1981;;123:104-109.
11 +
McSwiggan DA, Collins CH:  The isolation of M. kansasii and M. xenopi from water systems . Tubercle 1974;;55:291-297.
12 +
Masur H, Tuazon C, Gill V, et al:  Concise communications: Effect of combined clofazimine and ansamycin therapy on Mycobacterium avium-Mycobacterium intracellulare bacteremia in patients with AIDS . J Infest Dis 1987;;155:127-129.
13 +
du Moulin GC, Stottmeier KD:  Waterborne mycobacteria: An increasing threat to health . ASM News 1986;;52:525-529.
14 +
Stine TM, Harris AA, Levin S, et al:  A pseudoepidemic due to atypical mycobacteria in a hospital water supply . JAMA 1987;;258:809-811.
15 +
De Girolami PC, Tsang AY, du Moulin GC, et al:  Serovars of Mycobacterium avium complex isolated from patients with AIDS , abstract Q21. Abstracts of the 87th Annual Meeting of the American Society for Microbiology, Atlanta, 1987 .
16 +
Pelletier PA, du Moulin GC, Stottmeier KD:  Mycobacteria in public water supplies: Comparative resistance to chlorine . Microbiol Sci 1988;; 5:147-148.
17 +
O'Brien RJ, Geiter LJ, Snider DE:  The epidemiology of nontuberculous mycobacterial diseases in the United States . Am Rev Respir Dis 1987;;135:1007-1014.

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