Infectious Disease Danger in US Hospitals
The rare but troubling outbreak of bacterial infections in a Greenville, SC hospital is a symptom of yet another emerging disease. Mycobacterium abscessus is a rapidly growing mycobacteria (RGM), a distance relative of the bacteria that cause tuberculosis
and leprosy. M. abscessus was first described 1953 and later identified, in 1992, as a distinct strain of RGM. Mycobacteria can be found in soil, dust, rocks, bioaerosols, and water, including in harsh environments (e.g., low nutrients, low pH, and temperature extremes).
Research has shown M. abscessus to be present in water supplies, rainwater basins, and swimming pools, as well as in hospital water, dialysis and surgical equipment, and endoscopy cleaning equipment. M. abscessus is relatively resistant to standard disinfectants and to many antibiotics. Because of this, it has become the focus of research on a global scale.
Infection with M. abscessus is usually caused by injections of substances contaminated with the bacterium or through invasive medical procedures employing contaminated equipment or material. Infection can also occur after accidental injury where the wound is contaminated by soil. There is very little risk of transmission from person to person.
Because M. abscessus is all around us, understanding preventive measures is important. These measures are also classic. CDC recommends anyone who touches or cares for the infected site should wash their hands carefully with soap and water. Patients should follow all instructions given by their healthcare provider following any surgery or medical procedure. Avoid receiving procedures or injections by unlicensed persons.
The announcement that Dr. Sheik Umar Khan has contracted the very disease he has been battling in Sierra Leone is a vivid example of the danger faced by healthcare workers and those they treat. Highly contagious and with an exceptionally high fatality
rate -- 90 percent of those infected in the current outbreak have succumbed to the disease. Ebola transmission occurs in humans via direct contact with blood or bodily fluids from an infected person (including embalming the dead) or by contact with contaminated medical equipment such as needles. This is a particular problem in poor African nations (Ebola exists only on that continent) with under-equipped hospitals and poor practice of universal precautions. Frequent exposure can result in contracting your patient’s illnesses.
There is a natural correlation to venues and diseases less dramatic -- and scary -- then Ebola. Clinical staff treating communicable diseases from tuberculosis to influenza are exposed to those diseases. While we enjoy an abundance of medical materiel and generally effective communicable disease countermeasures, even these do not prevent all exposures. Influenza, for example, is transmissible before symptoms develop. This points, as always, to frequent hand washing, cough etiquette, staying current with vaccinations, and encouraging employees, students, and colleagues to stay home when ill.