Related Experiment Video
Updated: Mar 25, 2026
Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
Pacemaker pocket infection due to environmental mycobacteria: Successful management of an outbreak and steps for
Vijaya Bharat1, Vivek Hittinahalli2, Meenakshi Mishra3
1Head of the Department of Cardiology and in-charge ICU, Tata Main Hospital, Jamshedpur, India.
Background:
An outbreak of surgical site infection (SSI) due to environmental mycobacteria (EMB) occurred in a hospital in Eastern India.
Method:
A quality improvement project (QIP) was undertaken to analyze the causes and prevent further outbreak. Step (1) Proof of the need: Four patients who had undergone pacemaker implantation consecutively during a 10-day period developed SSI. Step (2) Diagnostic journey: Since all patients developed SSI within 2 months of implantation, a common source of infection was likely. Atypical mycobacteria (AMB) were grown from surgical sites as well as from the surface of operation table, image intensifier, and lead aprons. It was a rapid growing variety that lacked pigment, a characteristic of EMB with pathogenic potential. The EMB was finally traced to its source, the overhead water tank. Step (3) Remedial journey: By thorough cleaning of the water tank and enriching its chlorine content, the EMB was eliminated from its source. Step (4) Holding the gains: Protocol for cleaning the water tank once in 3 months was made. A checklist was prepared to ensure compliance to asepsis protocol in the operation theater. In the ensuing 5 years, the infection did not recur.
Result:
The bacteria that caused SSI were identified as EMB that grew in the water tank and contaminated the operation room. It could be eliminated by appropriate measures.
Interpretation:
Water is a potential reservoir for EMB. Use of the term 'environmental mycobacteria' instead of 'atypical mycobacteria' will generate awareness about contamination as the cause of SSI.
Insights
An outbreak of surgical site infections (SSI) was caused by environmental mycobacteria (EMB) from a hospital water tank. Cleaning the tank and improving protocols eliminated the EMB, preventing further infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- A hospital in Eastern India experienced a surgical site infection (SSI) outbreak.
- The infections were linked to environmental mycobacteria (EMB).
Purpose of the Study:
- To investigate the source of the EMB outbreak.
- To implement measures to prevent recurrent SSIs.
Main Methods:
- A quality improvement project was initiated following four consecutive SSI cases after pacemaker implantation.
- Environmental samples identified EMB in the operation theater and traced the source to an overhead water tank.
- The EMB was eradicated by cleaning the water tank and increasing chlorine levels.
Main Results:
- Environmental mycobacteria (EMB) were identified as the causative agent of the SSI outbreak.
- The EMB contaminated the operation room, originating from the hospital's water supply.
- Effective remediation measures successfully eliminated the EMB from the source.
Conclusions:
- Water systems can serve as reservoirs for environmental mycobacteria (EMB).
- Using the term 'environmental mycobacteria' highlights contamination as a cause of SSI.
- Sustained vigilance and protocol adherence are crucial for preventing future outbreaks.
More Related Videos
11:32Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
08:56Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
Related Concept Videos
01:29Endocarditis IV: Nursing Management
01:18Endocarditis III: Medical Management
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:26Mitral Stenosis III: Medical Management