Epidemiology and Infection

Research Article

Iatrogenic outbreak of M. chelonae skin abscesses

D. Camargoa1, C. Saada1, F. Ruiza2, M. E. Ramireza2, M. Linerosa2, G. Rodrigueza3, E. Navarroa2, B. Pulidoa2 and L. C. Orozcoa1*

a1 Laboratorio de Patologia, Instituto Nacional de Salud, AA 78091 CUAN, Sante Fé de Bogotá, D.C. Colombia, Sur América

a2 Departamento Administrativo de Salud del Atlántico, DASALUD, Edificio Loteria del Atlántico, Carrera 45 No. 44-12, Barranquilla, Colombia, Sur América

a3 Facultad de Medicina, Universidad Nacional, Bogota, Columbia, Sur América

Abstract

We describe an outbreak of skin lesions due to Mycobacterium chelonae subsp. abscessus associated with injections of lidocaine (lignocaine) given by a ‘bioenergetic’ (a practitioner of alternative medicine) in Colombia. The lidocaine carpules and the lesions of the patients yielded mycobacteria with identical biochemical characteristics.

Using the methodology of Sartwell and a case control design we examined the incubation period and assessed risk factors. Of 667 potentially exposed individuals, a total of 298 patients were interviewed, of whom 232 had skin lesions. The median incubation period was 30·5 days (range 15–59 days). Male sex (OR 2·85, 95% CI 1·26–6·51), increasing age (OR 1·25, 95% CI 1·03–1·53), subcutaneous injection route (OR 3·72, 95% CI 1·09–12·7) and number of injections (OR 1·01, 95% CI 1·00–1·03) were risk factors for disease.

To our knowledge, this is the largest reported outbreak of M. chelonae infection, the first in which the organism has been isolated from the putative vehicle of infection, and the first in which the incubation period could be determined.

(Accepted December 27 1995)

Footnotes

* Luis Carlos Orozco Vargas, AA 78091 CUAN, Santa Fé de Bogotá, D.C., Colombia, Sur América.

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