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NONTUBERCULOUS MYCOBACYERIA SPP ISOLATED FROM RESIDENTS OF KING COUNTY, WASHINGTON, 1999-2002
Citation:
Hilborn, E D., T C. Covert, M. Yakrus, G N. Stelma Jr., AND M Schmitt. NONTUBERCULOUS MYCOBACYERIA SPP ISOLATED FROM RESIDENTS OF KING COUNTY, WASHINGTON, 1999-2002. Presented at International Conference on Emerging and Infectious Diseases, Atlanta, GA, February 29-March 3, 2004.
Impact/Purpose:
1. To assess the prevalence of nontuberculous Mycobacterium species (NTM) in raw water, finished water, and in drinking water distribution systems before and after the addition of filtration and ozonation.
2. To assess the effect of the addition of filtration and ozonation on the percent of NTM from environmental sources that are genetically related to human isolates derived from the population served by municipal drinking water.
3. To assess the effect of the addition of filtration and ozonation on the prevalence of indicator bacteria and heterotrophic plate count bacteria in finished water and in drinking water distribution system biofilm. A comparison of strains of heterotrophic bacteria before and after the treatment change will be conducted.
4. To assess the effect of the addition of filtration and ozonation on the prevalence of other pathogens in finished water, and in drinking water distribution systems.
Description:
Background: Pathogenic nontuberculous Mycobacteria spp. (NTM) are not known to be transmitted among persons, but may be acquired from exposure to contaminated media such as soil, food and water. We examined the spectrum of NTM isolated from human specimens in King County, WA.
Methods: NTM were isolated from clinical specimens collected during 1999 - 2002 from patients residing in King Co., Washington. Participating laboratories collected isolates, the date and anatomical site of specimen collection, and the home zip code of the patient. NTM species were identified using multiple laboratory methods (molecular probe, biochemical characterization, high performance liquid chromatography). Data were analyzed with SAS 8.2. Isolates were described by species and anatomic site. Analyses of potential differences among specimen dates of collection were performed.
Results: A total of 507 NTM isolates were obtained from specimens collected during 1999 - 2002. NTM isolate numbers ranged from: 113 isolated from specimens collected during 2000, to 152 isolated from specimens collected during 1999. Complex or species level identification occurred in 94% (476/507) of isolates. Slow-growers comprised 83% (396/476) of isolates. Mycobacterium avium complex (MAC) comprised 65% (256/396) of the slow-growers. MAC were isolated from 203 respiratory sites (80%), 37 sterile sites (14%), 1 stool (0.4%) and 15 other sites (6%). The 80 rapid growers were isolated from 56 respiratory sites (70%), 9 sterile sites (11%), and 14 other sites (18%); 1 site was not recorded. Rapid growers were not all identified to the species level. No differences were seen in the numbers of isolates when compared among month or season of specimen collection.
Conclusions: Slow-growing species were identified in the majority of isolates. MAC was the most common NTM isolated from clinical specimens and from sterile sites. Respiratory specimens yielded the most NTM isolates, including those species not typically associated with infection. We found no evidence of seasonal differences among collected specimens.