First Mycobacterium abscessus Outbreak Associated With Recreational Water in the United States
Notice bibliographique
Résumé
Background. Mycobacterium abscessus, a rapidly growing acid-fast bacterium naturally found in water, soil, and dust, is an opportunistic pathogen that causes rare infections of the skin and subcutaneous tissues. Outbreaks of skin infections related to recreational water exposure were identified in Canada in 2003, and in Italy 2009–2011, but no previous outbreaks associated with recreational water in the United States had been reported. In Idaho, February–May 2013, M. abscessus skin infections were diagnosed in 11 children. Methods. Clinical evaluation of children, mycobacterial culture and identification, and epidemiologic and environmental investigations were performed. Results. Affected children were aged 2–6 years; 9 (82%) were female. All were otherwise healthy with no diagnosed immunocompromising conditions. Most children presented with erythematous nodular lesions on their hands or feet. In some cases, initial symptoms were attributed to viral hand, foot, and mouth disease. Illness onsets occurred January–May 2013. One case was confirmed as M. abscessus group not chelonae by bacterial RNA polymerase β subunit (rpoB) gene sequencing, 2 were confirmed as M. abscessus/chelonae complex by 16S rDNA sequence analysis, and in 2 cases, acid-fast bacilli were detected in fixed skin biopsy or smear of exudate; 6 additional clinically-compatible cases shared epidemiologic risk factors. Epidemiologic investigation determined that the sole common exposure among cases was playing in a fitness facility's wading pool December 2012–April 2013. Environmental investigation found a worn rubber mat on the bottom of the pool at the slide exit and worn polyurethane decking suspected to have allowed colonization by M. abscessus. Swabs of the fountain strainer and slide ladder cultured positive for M. abscessus/chelonae with pulsed-field gel electrophoresis patterns related, but not identical to those of clinical isolates. Mycobacterium spp. were isolated from the pool water. The pool operator hyperchlorinated, drained, scrubbed, and disinfected the pool. The worn rubber mat was replaced. No associated cases were reported after environmental remediation. Conclusion. An outbreak of M. abscessus skin infections among children was associated with a wading pool and controlled by environmental remediation. This was the first such reported outbreak in the United States. Disclosures. All authors: No reported disclosures.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».