Mycobacterium spp. (excluding M. tuberculosis) including ulcerans, abscessus, terrae
Morphology
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Aerobic, non-spore forming, non-motile, slightly curved or straight rods (0.2 to 0.6
μm by 1.0 to 10 μm) which may branch
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Disease
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Non-tuberculous mycobacteria (NTM) infections occur mainly in immunosuppressed individuals,
although immunocompetent patients can also be affected. Non tuberculous mycobacteria
cause many different diseases in humans.
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Zoonosis
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Yes for some species: M. marinum from pet fish, M. avium complex from swine, and from
other domestic and wild animals
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Host Range
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Humans, domestic and wild animals
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Modes of Transmission
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Nosocomial, direct contact with a contaminated environment
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Signs and Symptoms
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Cutaneous or skin infections
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Infectious Dose
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Unknown.
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Incubation Period
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unknown
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Prophylaxis
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None available.
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Vaccines
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None available.
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Treatment
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A combination of several antibiotics over long periods of time is recommended for
treatment of NTM infections. The most important antibiotics used in antimycobacterial
therapy include: rifampin, isoniazid, ethambutol, macrolides (clarithromycin, azithromycin),
quinolones (ciprofloxacin, moxifloxacin, gatifloxacin), aminoglycosides (streptomycin,
amikacin) and linezolid.
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Surveillance
|
Monitor for symptoms. Diagnosis of NTM infection can be done via culture of clinical
specimens, serotyping, and PCR.
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MSU Requirements
|
Report any exposures
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Laboratory Acquired Infections (LAIs)
|
40 cases of non pulmonary tuberculosis due to laboratory or autopsy room accidents
have been reported.
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Sources
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NTM can be isolated from sputa, exudates from lesions, tissues, environmental samples
(soil, water), and from wounds. Cultures, frozen stocks, other samples described in
IBC protocol.
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BMBL
|
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CDC
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NIH Guidelines
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Risk Group 2
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Agents that are associated with human disease which is rarely serious and for which preventive or therapeutic interventions are often available. |
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BSL2
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For all procedures involving suspected or known infectious specimen or cultures.
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ABSL2
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For all procedures utilizing infected animals.
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Small
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Notify others working in the lab. Remove PPE and don new PPE. Cover area of the spill
with absorbent material and add fresh 1:10 bleach:water. Allow 20 munutes (or as directed)
of contact time. After 20 minutes, cleanup and dispose of materials.
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Large
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Mucous membrane
|
Flush eyes, mouth, or nose for 5 minutes at eyewash station.
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Other Exposures
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Wash area with soap and water for 5 minutes.
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Reporting
|
Immediately report incident to supervisor, complete a First Report of Injury form, and submit to Safety and Risk Management.
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Medical Follow-up
|
During business hours: Bridger Occupational Health 3406 Laramie Drive. Weekdays 8am -6pm. Weekends 9am-5pm
After business hours: Bozeman Deaconess Hospital Emergency Room 915 Highland Blvd Bozeman, MT |
Disinfection
|
Mycobacteria are more resistant to disinfectants than vegetative bacteria. Susceptible
to sodium hydroxide, chlorine dioxide, ethylene oxide, 0.35% peracetic acid, and orthophthalaldehyde.
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Inactivation
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Inactivated by moist heat (60 minutes at 121oC) and dry heat (1 hour at 160-170oC).
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Survival Outside Host
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Weeks to months on inanimate objects if protected from sunlight.
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Minimum PPE Requirements
|
Lab coat, disposable gloves, safety glasses, closed toed shoes, long pants
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Additional Precautions
|
Additioanl PPE may be required depending on lab specific SOPs and IBC Protocol. |