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Mycobacterium xenopi spinal infections after discovertebral surgery: investigation and screening of a large outbreak

P Astagneau1, N Desplaces, V Vincent

  • 1C-CLIN Paris Nord, Paris, France. astagne@ext.jussieu.fr

Lancet (London, England)
|September 12, 2001
PubMed
Abstract

Insights

Failures in hygiene practices led to a Mycobacterium xenopi spinal infection outbreak. Prompt patient screening and information are crucial after iatrogenic infectious hazards to prevent nosocomial infections.

Area of Science:

  • Infectious Diseases
  • Hospital Epidemiology
  • Microbiology

Background:

  • An outbreak of Mycobacterium xenopi spinal infections occurred in a private hospital following surgical procedures.
  • Contaminated tap water used for rinsing surgical devices was identified as the source of the outbreak.
  • The long delay between surgery and diagnosis complicated initial control efforts.

Purpose of the Study:

  • To conduct a retrospective investigation of patients exposed to Mycobacterium xenopi contamination.
  • To identify the cumulative frequency and risk factors associated with M. xenopi spinal infections.

Main Methods:

  • A retrospective study involving mailing and media campaigns to trace exposed patients.
  • Screening of patients using magnetic resonance imaging (MRI).
  • Histopathological and bacteriological examination of discovertebral biopsies for suspected cases.

Main Results:

  • Out of 3244 exposed patients, 58 cases of M. xenopi spinal infection were identified (1.8% cumulative frequency).
  • The campaign identified 26 cases with a mean detection delay of 5.2 years.
  • Nucleotomy and a high number of patients per operating session were identified as risk factors.

Conclusions:

  • Failures in hygiene practices can lead to uncontrolled nosocomial infection outbreaks.
  • Prompt screening and effective patient information are essential following iatrogenic infectious hazards.

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