Water as a possible factor of transmission in mycobacterial infections

Mycobacterium kansasii and Mycobacterium xenopi are the most frequent species occurring in water in the Czech Republic. In the endemic area of M. kansasii in heavy industry and mining areas of North Moravia various mycobacterial species were detected in more than 20% of different water samples and M. kansasii was found in 1.5 to 1.9% of them, frequently in pit bathrooms and in the drinking water as well. Mycobacterium xenopi was detected in 35 and 50% of water samples collected in households of M. xenopi excretors in North Bohemia and in Prague. A nosocomial occurrence of M. xenopi was recorded in an hospital department in North Bohemia and in a rest home in Prague and all samples of water from the afflicted institutions were positive for M. xenopi. In a coal mine in Moravia a case of cutaneous involvement associated with the presence of M. marinum in mine water was also recorded. The incidence of various mycobacterial species (except of M. kansasii and M. xenopi) in spa and swimming pools in West Bohemia reached 35% positivity. Comprehensive reviews of bacteriological investigations for mycobacteria performed in the entire territory of the Czech Republic have been reported in annual reports since 1985. In the period from 1985 to 1991 a total of 5167 samples of various kinds of water samples were examined and mycobacteria were detected in 8.2 to 47.7% of them.