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Published on: June 11, 2011
Nosocomial outbreak of Microbacterium species bacteremia among cancer patients
J Alonso-Echanove1, S S Shah, A J Valenti
1Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. jalonso-echanove@cdc.gov
Abstract:
To date, only 6 sporadic Microbacterium species (formerly coryneform Centers for Disease Control and Prevention [CDC] groups A-4 and A-5) infections have been reported. The source, mode of transmission, morbidity, mortality, and potential for nosocomial transmission of Microbacterium species remain unknown. From 26 July through 14 August 1997, 8 episodes of coryneform CDC group A-5 symptomatic bacteremia occurred in 6 patients on the oncology ward at the Maine Medical Center. One patient died. All isolates were identified at CDC as Microbacterium species and had identical DNA banding patterns by pulsed-field gel electrophoresis. To assess risk factors for Microbacterium species infection, a retrospective cohort study was conducted. The presence of a central venous catheter was the strongest risk factor (6/6 vs. 22/48; relative risk, 3.2; P<.0001). This outbreak demonstrates significant Microbacterium species-associated morbidity and mortality in immunocompromised populations and confirms the potential for epidemic nosocomial transmission.
Insights
Microbacterium species infections, previously rare, caused bacteremia in oncology patients, leading to one death. Central venous catheters were identified as a significant risk factor for these nosocomial infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Limited data exists on Microbacterium species infections, including their transmission and impact.
- Sporadic cases of Microbacterium species (formerly CDC groups A-4 and A-5) have been reported.
Observation:
- An outbreak of 8 symptomatic bacteremia episodes caused by Microbacterium species occurred in 6 oncology patients.
- The outbreak took place at Maine Medical Center between July 26 and August 14, 1997.
- One patient succumbed to the infection, highlighting potential mortality.
Findings:
- All isolates were identified as Microbacterium species with identical DNA profiles.
- A retrospective cohort study identified central venous catheter use as the strongest risk factor (RR 3.2, P<.0001).
Implications:
- This outbreak underscores the significant morbidity and mortality associated with Microbacterium species in immunocompromised patients.
- The findings confirm the potential for epidemic nosocomial transmission of these bacteria.
- Highlights the need for vigilance and infection control measures in healthcare settings, particularly for vulnerable populations.
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