Abstract
We describe nontuberculous mycobacteria (NTM) infections during 2012–2020 associated with health care and aesthetic procedures in France. We obtained epidemiologic data from the national early warning response system for healtcare-associated infections and data on NTM isolates from the National Reference Center for Mycobacteria. We compared clinical and environmental isolates by using whole-genome sequencing. The 85 original cases were reported after surgery (48, 56%), other invasive procedures (28, 33%) and other procedures (9, 11%). NTM isolates belonged to rapidly growing (73, 86%) and slowly growing (10, 12%) species; in 2 cases, the species was not identified. We performed environmental investigations for 38 (45%) cases; results for 12 (32%) were positive for the same NTM species as for the infection. In 10 cases that had environmental and clinical samples whose genomes were similar, the infection source was probably the water used in the procedures. NTM infections could be preventable by using sterile water in all invasive procedures.
Highlights
nontuberculous mycobacteria (NTM) are classified according to their speed of growth in vitro, rapidly growing mycobacteria and slowly growing mycobacteria
This finding was especially observed for extrapulmonary NTM infections after invasive procedures because of a common source, such as healthcare-associated infections (HAIs) and those related to medical, aesthetic, or cosmetic procedures [3–7]
NTM HAIs were observed after heart surgery: >100 cases of endocarditis caused by a single clone of M. chimaera were found in water tanks of heater-cooler units used for cardiac bypass [8]
Summary
We describe nontuberculous mycobacteria (NTM) infections during 2012–2020 associated with health care and aesthetic procedures in France. NTM infections are usually not transmissible between humans, outbreaks linked to the same contamination event or from a common water reservoir have been reported. This finding was especially observed for extrapulmonary NTM infections after invasive procedures because of a common source, such as healthcare-associated infections (HAIs) and those related to medical, aesthetic, or cosmetic procedures [3–7]. In France, previously reported outbreaks of NTM HAI cases have involved M. xenopi in bone and joint infections after orthopedic surgery [9] and M. chelonae in skin infections after mesotherapy cosmetic procedures [5] or in hematopoietic stem cell transplantation [10]. The National Reference Centre for Mycobacteria and Resistance of Mycobacteria to Anti-Tuberculosis Agents (CNRMyRMA) regularly receives NTM isolates, including
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