Nontuberculous Mycobacteria under Scrutiny in the Geneva Area (2015–2020)

Respiration ◽  
2021 ◽  
pp. 1-9
Author(s):  
Rechana Vongthilath-Moeung ◽  
Jérôme Plojoux ◽  
Antoine Poncet ◽  
Gesuele Renzi ◽  
Nicolas Veziris ◽  
...  
Keyword(s):  
Nontuberculous Mycobacteria ◽  
Specific Treatment ◽  
Positive Culture ◽  
University Hospital ◽  
Mycobacterium Chelonae ◽  
Mycobacterium Xenopi ◽  
Episodes Of Care ◽  
Low Bmi ◽  
Relative Prevalence ◽  
Culture Positive

<b><i>Background:</i></b> Nontuberculous mycobacteria (NTM) are increasingly identified in industrialized countries, and their role as pathogens is more frequently recognized. The relative prevalence of NTM strains shows an important geographical variability. Thus, establishing the local relative prevalence of NTM strains is relevant and useful for clinicians. <b><i>Methods:</i></b> Retrospective analysis (2015–2020) of a comprehensive database was conducted including all results of cultures for mycobacteria in a University Hospital (Geneva, Switzerland), covering a population of approximately 500,000 inhabitants. All NTM culture-positive patients were included in the analyses. Patients’ characteristics, NTM strains, and time to culture positivity were reported. <b><i>Results:</i></b> Among 38,065 samples analyzed during the study period, 411 were culture-positive for NTM, representing 236 strains, and 231 episodes of care which occurred in 222 patients. Patients in whom NTM were identified were predominantly female (55%), with a median age of 62 years, and a low BMI (median: 22.6 kg/m<sup>2</sup>). The <i>Mycobacterium avium</i> complex (MAC) was the most frequently identified group (37% of strains) followed by <i>Mycobacterium gordonae</i> (25%) and <i>Mycobacterium xenopi</i> (12%) among the slowly growing mycobacteria (SGM), while the <i>Mycobacterium chelonae/abscessus</i> group (11%) were the most frequently identified rapidly growing mycobacteria (RGM). Only 19% of all patients were treated, mostly for pulmonary infections: the MAC was the most frequently treated NTM (<i>n</i> = 19, 43% of cases in patients treated) followed by RGM (<i>n</i> = 15, 34%) and <i>M. xenopi</i> (<i>n</i> = 6, 14%). Among those treated, 23% were immunosuppressed, 12% had pulmonary comorbidities, and 5% systemic comorbidities. Cultures became positive after a median of 41 days (IQR: 23; 68) for SGM and 28 days (14; 35) for RGM. <b><i>Conclusions:</i></b> In Western Switzerland, <i>M. avium</i> and <i>M. gordonae</i> were the most prevalent NTM identified. Positive cultures for NTM led to a specific treatment in 19% of subjects. Patients with a positive culture for NTM were mostly female, with a median age of 62 years, a low BMI, and a low prevalence of immunosuppression or associated severe comorbidities.

scholarly journals Secondary bacterial infections and antimicrobial resistance in COVID-19: comparative evaluation of pre-pandemic and pandemic-era, a retrospective single center study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Mustafa Karataş ◽  
Melike Yaşar-Duman ◽  
Alper Tünger ◽  
Feriha Çilli ◽  
Şöhret Aydemir ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Respiratory Infections ◽  
Low Frequency ◽  
Positive Culture ◽  
Positive Sample ◽  
University Hospital ◽  
Control Groups ◽  
Extended Spectrum Beta Lactamase ◽  
Culture Positive

Abstract Purpose In this study, we aimed to evaluate the epidemiology and antimicrobial resistance (AMR) patterns of bacterial pathogens in COVID-19 patients and to compare the results with control groups from the pre-pandemic and pandemic era. Methods Microbiological database records of all the COVID-19 diagnosed patients in the Ege University Hospital between March 15, 2020, and June 15, 2020, evaluated retrospectively. Patients who acquired secondary bacterial infections (SBIs) and bacterial co-infections were analyzed. Etiology and AMR data of the bacterial infections were collected. Results were also compared to control groups from pre-pandemic and pandemic era data. Results In total, 4859 positive culture results from 3532 patients were analyzed. Fifty-two (3.59%) patients had 78 SBIs and 38 (2.62%) patients had 45 bacterial co-infections among 1447 COVID-19 patients. 22/85 (25.88%) patients died who had bacterial infections. The respiratory culture-positive sample rate was 39.02% among all culture-positive samples in the COVID-19 group. There was a significant decrease in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales (8.94%) compared to samples from the pre-pandemic (20.76%) and pandemic era (20.74%) (p = 0.001 for both comparisons). Interestingly, Acinetobacter baumannii was the main pathogen in the respiratory infections of COVID-19 patients (9.76%) and the rate was significantly higher than pre-pandemic (3.49%, p < 0.002) and pandemic era control groups (3.11%, p < 0.001). Conclusion Due to the low frequency of SBIs reported during the ongoing pandemic, a more careful and targeted antimicrobial prescription should be taken. While patients with COVID-19 had lower levels of ESBL-producing Enterobacterales, the frequency of multidrug-resistant (MDR) A. baumannii is higher.

scholarly journals Secondary Bacterial Infections and Antimicrobial Resistance in COVID-19: Comparative Evaluation of Pre-Pandemic and Pandemic-Era, A Retrospective Single Center Study

2021 ◽  
Author(s):  
Mustafa Karataş ◽  
Melike Yaşar Duman ◽  
Alper Tünger ◽  
Feriha Çilli ◽  
Şöhret Aydemir ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Bacterial Infections ◽  
Respiratory Infections ◽  
Low Frequency ◽  
Positive Culture ◽  
Positive Sample ◽  
University Hospital ◽  
Control Groups ◽  
Extended Spectrum Beta Lactamase ◽  
Culture Positive

Abstract Purpose: In this study, we aimed to evaluate the epidemiology and antimicrobial resistance (AMR) patterns of bacterial pathogens in COVID-19 patients and to compare the results with control groups from the pre-pandemic and pandemic era.Methods: Microbiological database records of all the COVID-19 diagnosed patients in the Ege University Hospital between March 15, 2020, and June 15, 2020, evaluated retrospectively. Patients who acquired secondary bacterial infections (SBIs) and bacterial co-infections were analyzed. Etiology and AMR data of the bacterial infections were collected. Results were also compared to control groups from pre-pandemic and pandemic era data.Results: In total, 4,859 positive culture results from 3,532 patients were analyzed. Fifty-two (3.59%) patients had 78 SBIs and 38 (2.62%) patients had 45 bacterial co-infections among 1,447 COVID-19 patients. 22/85 (25.88%) patients died who had bacterial infections. The respiratory culture-positive sample rate was 39.02% among all culture-positive samples in the COVID-19 group. There was a significant decrease in extended-spectrum beta-lactamase-producing Enterobacterales (8.94%) compared to samples from the pre-pandemic (20.76%) and pandemic era (20.74%) (p=0.001 for both comparisons). Interestingly, Acinetobacter baumannii was the main pathogen in the respiratory infections of COVID-19 patients (%9.76) and the rate was significantly higher than pre-pandemic (3.49%, p<0.002) and pandemic era control groups (3.11%, p<0.001).Conclusion: Due to the low frequency of SBIs reported during the ongoing pandemic, a more careful and targeted antimicrobial prescription should be taken. While patients with COVID-19 had lower levels of ESBL producing Enterobacterales, the frequency of MDR A. baumannii is higher.

scholarly journals The Prevalence and Clinical Significance of Anaerobic Bacteria in Major Liver Resection

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 139
Author(s):  
Jens Strohäker ◽  
Sophia Bareiß ◽  
Silvio Nadalin ◽  
Alfred Königsrainer ◽  
Ruth Ladurner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anaerobic Bacteria ◽  
Positive Culture ◽  
Infectious Complications ◽  
University Hospital ◽  
Clinical Role ◽  
Liver Resections ◽  
Management Of Complications ◽  
Anaerobic Infections ◽  
Major Hepatectomies

(1) Background: Anaerobic infections in hepatobiliary surgery have rarely been addressed. Whereas infectious complications during the perioperative phase of liver resections are common, there are very limited data on the prevalence and clinical role of anaerobes in this context. Given the risk of contaminated bile in liver resections, the goal of our study was to investigate the prevalence and outcome of anaerobic infections in major hepatectomies. (2) Methods: We retrospectively analyzed the charts of 245 consecutive major hepatectomies that were performed at the department of General, Visceral, and Transplantation Surgery of the University Hospital of Tuebingen between July 2017 and August 2020. All microbiological cultures were screened for the prevalence of anaerobic bacteria and the patients’ clinical characteristics and outcomes were evaluated. (3) Results: Of the 245 patients, 13 patients suffered from anaerobic infections. Seven had positive cultures from the biliary tract during the primary procedure, while six had positive culture results from samples obtained during the management of complications. Risk factors for anaerobic infections were preoperative biliary stenting (p = 0.002) and bile leaks (p = 0.009). All of these infections had to be treated by intervention and adjunct antibiotic treatment with broad spectrum antibiotics. (4) Conclusions: Anaerobic infections are rare in liver resections. Certain risk factors trigger the antibiotic coverage of anaerobes.

scholarly journals Comparison of Culture Methods for Isolation of Nontuberculous Mycobacteria from Surface Waters

2010 ◽  
Vol 76 (11) ◽  
pp. 3514-3520 ◽  
Author(s):  
Nicolas Radomski ◽  
Emmanuelle Cambau ◽  
Laurent Moulin ◽  
Sophie Haenn ◽  
R�gis Moilleron ◽  
...  
Keyword(s):  
Nontuberculous Mycobacteria ◽  
Cetylpyridinium Chloride ◽  
Competitive Growth ◽  
Culture Methods ◽  
Mycobacterium Chelonae ◽  
Water Testing ◽  
Antibiotic Cocktail ◽  
Rich Media ◽  
Human Infections

ABSTRACT The environment is the likely source of most nontuberculous mycobacteria (NTM) involved in human infections, especially pulmonary, skin, and soft tissue infections. In order to measure the prevalence of NTM in different aquatic ecosystems, we tried to standardize the culture methods used for surface water testing since many procedures have been described previously. Cultivation of mycobacteria requires long-term incubation in rich media and inactivation of rapidly growing microorganisms whose growth impedes observation of mycobacterial colonies. Consequently, the two criteria used for evaluation of the methods examined were (i) the rate of inhibition of nontarget microorganisms and (ii) the efficiency of recovery of mycobacteria. We compared the competitive growth of Mycobacterium chelonae and M. avium with nontarget microorganisms on rich Middlebrook 7H11-mycobactin medium after treatment by several chemical decontamination methods that included acids, bases, detergent, or cetylpyridinium chloride (CPC) with and without an antibiotic cocktail, either PANTA (40 U/ml polymyxin, 4 μg/ml amphotericin B, 16 μg/ml nalidixic acid, 4 μg/ml trimethoprim, and 4 μg/ml azlocillin) or PANTAV (PANTA plus 10 μg/ml vancomycin). Our results showed that treatment for 30 min with CPC (final concentration, 0.05%) of water concentrated by centrifugation, followed by culture on a rich medium supplemented with PANTA, significantly decreased the growth of nontarget microorganisms (the concentrations were 6.2 � 0.4 log10 CFU/liter on Middlebrook 7H11j medium and 4.2 � 0.2 log10 CFU/liter on Middlebrook 7H11j medium containing PANTA [P < 0.001]), while the effect of this procedure on NTM was not as great (the concentrations of M. chelonae on the two media were 7.0 � 0.0 log10 CFU/liter and 6.9 � 0.0 log10 CFU/liter, respectively, and the concentrations of M. avium were 9.1 � 0.0 log10 CFU/liter and 8.9 � 0.0 log10 CFU/liter, respectively). We propose that this standardized culture procedure could be used for detection of NTM in aquatic samples.

scholarly journals Percutaneous Bone Biopsy for Diabetic Foot Osteomyelitis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Marcos C Schechter ◽  
Mohammed K Ali ◽  
Benjamin B Risk ◽  
Adam D Singer ◽  
Gabriel Santamarina ◽  
...  
Keyword(s):  
Adverse Events ◽  
Diabetic Foot ◽  
Bone Biopsy ◽  
Meta Analysis ◽  
Positive Culture ◽  
High Yield ◽  
Analysis Model ◽  
Antibiotic Management ◽  
Culture Positive ◽  
Diabetic Foot Osteomyelitis

Abstract Background Diabetes is the leading cause of lower extremity nontraumatic amputation globally, and diabetic foot osteomyelitis (DFO) is usually the terminal event before limb loss. Although guidelines recommend percutaneous bone biopsy (PBB) for microbiological diagnosis of DFO in several common scenarios, it is unclear how frequently PBBs yield positive cultures and whether they cause harm or improve outcomes. Methods We searched the PubMed, EMBASE, and Cochrane Trials databases for articles in any language published up to December 31, 2019, reporting the frequency of culture-positive PBBs. We calculated the pooled proportion of culture-positive PBBs using a random-effects meta-analysis model and reported on PBB-related adverse events, DFO outcomes, and antibiotic adjustment based on PBB culture results where available. Results Among 861 articles, 11 studies met inclusion criteria and included 780 patients with 837 PBBs. Mean age ranged between 56.6 and 71.0 years old. The proportion of males ranged from 62% to 86%. All studies were longitudinal observational cohorts, and 10 were from Europe. The range of culture-positive PBBs was 56%–99%, and the pooled proportion of PBBs with a positive culture was 84% (95% confidence interval, 73%–91%). There was heterogeneity between studies and no consistency in definitions used to define adverse events. Impact of PBB on DFO outcomes or antibiotic management were seldom reported. Conclusions This meta-analysis suggests PBBs have a high yield of culture-positive results. However, this is an understudied topic, especially in low- and middle-income countries, and the current literature provides very limited data regarding procedure safety and impact on clinical outcomes or antibiotic management.

Non-touch Aseptic technique Maintains Sterility of Antibiotic-Admixed peritoneal Dialysis Fluid

2018 ◽  
Vol 38 (1) ◽  
pp. 65-67
Author(s):  
Louis L. Huang ◽  
Ellen Ramas ◽  
Priti Prasad ◽  
Jenny Catania ◽  
Pauline Meade ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Room Temperature ◽  
Positive Culture ◽  
Coagulase Negative Staphylococcus ◽  
Dialysis Fluid ◽  
Aseptic Technique ◽  
Sterile Technique ◽  
Peritoneal Dialysis Fluid ◽  
Culture Positive ◽  
Positive Controls

There is a paucity of data on the sterility of peritoneal dialysis fluid (PDF) after drug admixture. International Society for Peritoneal Dialysis (ISPD) guidelines suggest using sterile technique when admixing antibiotics; however, the degree of sterility remains unclear. This issue is most pertinent when preparing take-home PDF for outpatient treatment of peritonitis. This study compares the sterility of PDF admixed with antibiotics using a non-touch aseptic technique (NTAT) versus sterile technique. Groups of 8 PDF mixtures (1.5% Dianeal or Icodextrin [Baxter International Inc., Spring Grove, IL, USA]) were admixed with 1 g/L ceftazidime and vancomycin, or 20 mL saline, either by a pharmacist using sterile technique in a sterile suite, or a nurse in a clinical room using NTAT. Dianeal inoculated with 1 x 106 colony-forming units (CFU)/L of coagulase-negative Staphylococcus (CNS), with and without antibiotics, served as positive controls. Admixed PDFs were left at room temperature for 72 hours, then cultured using the BacT/ALERT system. A positive culture by day 5 constituted a contamination. Differences in proportion of contamination between groups were assessed using the Chi-squared test. Eighty PDF bags underwent microbiological testing. Sterility was maintained in all bags, independent of technique (NTAT versus sterile technique), type of PDF (Dianeal versus Icodextrin), or whether antibiotics were admixed. Of the positive controls, CNS-inoculated PDFs without antibiotics were all culture positive; however, when inoculated into antibiotic-admixed PDFs, only S. haemolyticus remained culture-positive ( p < 0.0001). In conclusion, PDF sterility can be maintained using NTAT for up to 3 days at room temperature. Currently, there is insufficient evidence to adopt sterile technique in sterile suites when admixing take-home PDF.

scholarly journals Surveillance for Invasive Salmonella Disease in Bamako, Mali, From 2002 to 2018

2020 ◽  
Vol 71 (Supplement_2) ◽  
pp. S130-S140
Author(s):  
William L Still ◽  
Milagritos D Tapia ◽  
Sharon M Tennant ◽  
Mamadou Sylla ◽  
Aliou Touré ◽  
...  
Keyword(s):  
Bacterial Infection ◽  
Tertiary Care ◽  
Case Fatality ◽  
Positive Culture ◽  
Bloodstream Infections ◽  
Hospitalized Children ◽  
Childhood Morbidity ◽  
Invasive Bacterial Infection ◽  
Microbiological Techniques ◽  
Culture Positive

Abstract Background Salmonella enterica bloodstream infections are an important cause of childhood morbidity and mortality, including in Mali. We report 17 years of surveillance for nontyphoidal and typhoidal S. enterica infections among inpatients and outpatients at l’Hôpital Gabriel Touré, the main source of pediatric tertiary care in Bamako, Mali. Methods Between June 2002 and December 2018, a blood culture was collected from 54 748 children aged ≤15 years with fever and/or suspected invasive bacterial infection who provided consent (38 152 inpatients, 16 596 outpatients). Bacterial pathogens were identified using standard microbiological techniques and serovars of S. enterica were determined by PCR and/or agglutination with antisera. Results Nontyphoidal Salmonella (NTS) was identified in 671 enrolled inpatients (1.8% of all enrolled inpatients, 13.8% of enrolled inpatients with a positive culture). S. Enteritidis, the most common NTS serovar, accounted for 38.5% of all NTS isolates (n = 258), followed by S. Typhimurium (31.7%, n = 213). The median (SD) age of children with a culture positive for NTS was 1.8 (3) years. Overall case fatality was 20.9%. An additional 138 inpatients (0.4%) had a positive culture for typhoidal Salmonella. NTS was identified in 11 outpatients (0.07%), while typhoidal Salmonella was found in 49 outpatients (0.3%). The annual incidence of invasive NTS disease decreased over the study period, but case fatality remained high. Conclusions Although incidence decreased, NTS remained a major cause of invasive bacterial infection and mortality among hospitalized children in Bamako, while typhoidal Salmonella was uncommon. Because 87% of NTS belonged to only 4 serovars, a multivalent vaccine may be an effective strategy to reduce the burden and mortality of invasive NTS.

scholarly journals Lead-Related Infective Endocarditis in Latvia: A Single Centre Experience

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 566
Author(s):  
Nesterovics ◽  
Nesterovics ◽  
Stradins ◽  
Kalejs ◽  
Ansabergs ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Electronic Devices ◽  
Positive Culture ◽  
Major Complication ◽  
Heart Rhythm ◽  
University Hospital ◽  
Lead Extraction ◽  
Coagulase Negative Staphylococci ◽  
Cardiac Implantable Electronic Devices ◽  
Common Location

Background and Objectives: Over the last five decades cardiac implantable electronic devices (CIED) have become established as the mainstay for the treatment of permanent bradycardias, chronic heart failure and dangerous heart rhythm disturbances. These devices improve survival and quality of life in many patients. However, infections associated with CIED implantation, particularly lead-related infective endocarditis (LRIE), can offset all benefits and make more harm than good for the patient. To date, there are no other studies in Latvia, addressing patients with lead-related infective endocarditis. The objective of this study was to identify the most common pathogens associated with LRIE and their antimicrobial resistance and to identify possible risk factors of patients who present with LRIE. Materials and Methods: The study was performed retrospectively at Pauls Stradins Clinical University Hospital (PSCUH). The study included patients who were referred to PSCUH due to LRIE for lead extraction. Patients were identified from procedural journals. Information about isolated microorganisms, patient comorbidities and visual diagnostics data was taken from patient records. Results: Forty-nine patients with CIED related infective endocarditis were included in the study, 34 (69.4%) were male, median age of all patients was 65.0 (50.5–73.0) years, median hospital stay was 15.5 (22.0–30.5) days. Successful and complete lead extraction was achieved in all patients. Thirty-two (65.3%) had received antibiotics prior to blood sample. Only in 31 (63.3%) positive culture results were seen. The most common isolated pathogens were Staphylococcus aureus (23.5%) and coagulase negative staphylococci (23.5%). Other bacteria were isolated considerably less often. The atrial lead was most common location for lead vegetations, seen in 50.0% of cases. Five (10.2%) patients have died due to the disease. Conclusions: Lead-related infective endocarditis is a major complication of cardiac implantable electronic devices with considerable morbidity and mortality, which in our study was as high as 10.2%.

scholarly journals Relationship between Body Mass Index and T-Scores of Bone Mineral Density in the Hip and Spine Regions among Older Adults with Diabetes: A Retrospective Review

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Abdulaziz F. Hariri ◽  
Mohammad N. Almatrafi ◽  
Aws B. Zamka ◽  
Abdullah S. Babaker ◽  
Tariq M. Fallatah ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Femoral Neck ◽  
Body Mass ◽  
Bone Mineral ◽  
University Hospital ◽  
Lumbar Region ◽  
Mineral Density ◽  
Patients With Diabetes ◽  
Low Bmi

Diabetes mellitus (DM) cases are increasing worldwide, especially in Saudi Arabia. Previous studies suggested a positive relationship between body mass index (BMI) and bone mineral density (BMD) levels. Generally, patients with low BMI (<18.5 kg/m2) have reduced BMD levels and, thus, low T-scores; hence, they are categorized as osteopenic or osteoporotic. In this study, we aimed to determine whether a relationship between BMI and BMD T-scores in the hip and spine regions of patients with diabetes exists. This retrospective record review investigated older adult patients with diabetes in King Abdulaziz University Hospital (n=198; age 50–90 years) who underwent BMD scan between January 1, 2016, and June 25, 2018, regardless of their sex but limited to type 2 DM. The height and weight of all subjects were recorded, and BMI was calculated and categorized. We used SPSS version 21 for data analysis; measures of central tendencies, Pearson’s correlations, chi-square tests, and independent t-tests were employed. We found positive relationships between BMI and BMD T-scores in the hip and spine regions (right femoral neck: R=+0.214, P≤0.002; total right hip: R=+0.912, P≤0.001; left femoral neck: R=+0.939, P≤0.001; total left hip: R=+0.885, P≤0.001; and total lumbar region: R=+0.607, P≤0.001). Low BMI (<18.5 kg/m2) could be a risk factor for osteoporosis, whereas normal/high BMI could be protective against osteoporosis among adults with diabetes.

scholarly journals 927. Tap Water Avoidance Decreases Rates of Nontuberculous Mycobacteria in Intensive Care Units

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S29-S30 ◽  
Author(s):  
Arthur W Baker ◽  
Becky Smith ◽  
Daniel J Sexton ◽  
Kirk Huslage ◽  
Jason E Stout ◽  
...  
Keyword(s):  
Patient Care ◽  
Nontuberculous Mycobacteria ◽  
Tap Water ◽  
Positive Culture ◽  
Water Sources ◽  
Incidence Rates ◽  
Sterile Water ◽  
Intervention Period ◽  
Symptomatic Infection ◽  
Outbreak Period

Abstract Background We recently investigated a clonal outbreak of Mycobacterium abscessus molecularly linked to a colonized water supply at a new hospital addition. Use of sterile water instead of tap water for patient care in ICUs successfully mitigated the respiratory phase of the outbreak. We hypothesized that avoidance of tap water would also be associated with decreased respiratory isolation of other nontuberculous mycobacteria (NTM). Methods We analyzed all positive cultures for NTM obtained at our hospital from August 2013 through December 2015. The pre-intervention outbreak period was defined as August 2013 through May 2014; the tap water avoidance intervention period was defined as June 2014 through December 2015. NTM isolation was defined as a positive culture from a respiratory specimen obtained from an ICU patient on day 3 or later of hospitalization. We also performed AFB cultures of biofilms obtained from ICU water sources. Results NTM were isolated from 137 patients during 70,168 patient-days (figure). NTM isolation decreased from 41.0 patients/10,000 patient-days in the outbreak period to 9.9 patients/10,000 patient-days in the intervention period (IRR, 0.24; 95% CI, 0.17–0.34; P &lt; .0001) (table). Incidence rates of the 4 most common NTM (M. abscessus, M. chelonae/immunogenum, M. avium complex, and M. gordonae) also markedly decreased. Biofilm cultures were positive for at least 1 NTM isolate in 25 of 33 (76%) ICU water sources, including M. abscessus (n = 11, 33%), M. chelonae/immunogenum (n = 11, 33%), and M. gordonae (n = 11, 33%). Conclusion The use of sterile water for ICU patient care substantially decreased NTM isolation from patient respiratory specimens, presumably reducing risk of symptomatic infection. Hospitals with endemic NTM should consider tap water avoidance for high-risk patients. Disclosures All authors: No reported disclosures.

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