Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 28, Number 6—June 2022
Letter

Association of Healthcare and Aesthetic Procedures with Infections Caused by Nontuberculous Mycobacteria, France, 2012–2020

Cite This Article

To the Editor: Daniau et al. (1) described extrapulmonary nontuberculous mycobacteria (NTM) infections associated with medical procedures in France, highlighting the need for timely case reporting and genomic analysis to identify outbreak causes and prevent infections. On the basis of our experience investigating NTM healthcare-associated infections (HAIs) and outbreaks, we believe that an enhanced approach toward NTM that recognizes early signals of potential outbreaks and promptly uses the skills and investigative expertise of public health professionals is integral to mitigating disease spread. NTM pose substantial costs and burdens for patients, contributing to more hospitalizations and deaths than other waterborne pathogens (2). Among Centers for Disease Control and Prevention consultations for waterborne HAI outbreaks, 30% were caused by NTM, accounting for 40% of cases and further substantiating need to prevent transmission in healthcare facilities (3). Extrapulmonary NTM infections can be challenging to detect because of their long incubation period and nonspecific signs and symptoms, which raises concern that many healthcare-associated cases are unidentified (4).

Clinical vigilance and systematic surveillance for extrapulmonary NTM HAIs are urgently needed to detect cases, assist public health investigations, and reduce patient illness and death (4). Surveillance signals should trigger robust investigations, inclusive of active case-finding efforts, such as notification of potentially exposed patients, which has previously led to discovery of multiple additional cases (3). Investigating NTM HAIs may point to upstream causes of infection in the healthcare delivery process, such as contaminated medical products or poor infection control practices, requiring elimination of sources and appropriate interventions (4). Recommendations from experts and scientific evidence suggest that even a single extrapulmonary NTM HAI should prompt additional investigation (5). NTM HAIs are an emerging threat to patients and carry serious consequences for patient safety. Comprehensive NTM case investigations with public health engagement are needed to inform best practices and minimize infection burdens for patients and healthcare facilities.

Top

Kiara X. McNamaraComments to Author , Joseph F. Perz, and Kiran M. Perkins
Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Top

References

  1. Daniau  C, Lecorche  E, Mougari  F, Benmansour  H, Bernet  C, Blanchard  H, et al. Association of healthcare and aesthetic procedures with infections caused by nontuberculous mycobacteria, France, 2012‒2020. Emerg Infect Dis. 2022;28:51826. DOIPubMedGoogle Scholar
  2. Collier  SA, Deng  L, Adam  EA, Benedict  KM, Beshearse  EM, Blackstock  AJ, et al. Estimate of burden and direct healthcare cost of infectious waterborne disease in the United States. Emerg Infect Dis. 2021;27:1409. DOIPubMedGoogle Scholar
  3. Perkins  KM, Reddy  SC, Fagan  R, Arduino  MJ, Perz  JF. Investigation of healthcare infection risks from water-related organisms: Summary of CDC consultations, 2014-2017. Infect Control Hosp Epidemiol. 2019;40:6216. DOIPubMedGoogle Scholar
  4. Crist  MB, Perz  JF. Modern healthcare versus nontuberculous mycobacteria: who will have the upper hand? Clin Infect Dis. 2017;64:9123.PubMedGoogle Scholar
  5. The Council for Outbreak Response. Healthcare-Associated Infections (HAIs) and Antimicrobial-Resistant Pathogens. Proposed investigation/reporting thresholds and outbreak definition for extrapulmonary nontuberculous mycobacteria [cited 2022 Mar 22]. https://www.corha.org/wp-content/uploads/2019/09/CORHA-Proposed-NTM-Thresholds-and-Definition-08-19.pdf

Top

Cite This Article

DOI: 10.3201/eid2806.220520

Original Publication Date: May 12, 2022

Related Links

Top

Table of Contents – Volume 28, Number 6—June 2022

EID Search Options
presentation_01 Advanced Article Search – Search articles by author and/or keyword.
presentation_01 Articles by Country Search – Search articles by the topic country.
presentation_01 Article Type Search – Search articles by article type and issue.

Top

Comments

Please use the form below to submit correspondence to the authors or contact them at the following address:

Kiara X. McNamara, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30329-4027, USA

Send To

10000 character(s) remaining.

Top

Page created: April 11, 2022
Page updated: May 22, 2022
Page reviewed: May 22, 2022
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external