Mycobacterium spp. (non-tuberculous) including M. ulcerans
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
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Monitor for symptoms. Diagnosis of NTM infection can be done via culture of clinical
specimens, serotyping, and PCR.
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MSU Requirements
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Report any exposures
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Laboratory Acquired Infections (LAIs)
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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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Canadian MSDS:
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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
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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
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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
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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
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Susceptible to sodium hydroxide, chlorine dioxide, ethylene oxide, 0.35% peracetic
acid, and orthophthalaldehyde. 70% ethanol can be used for surface disinfection. Some
atypical mycobacteria such as M. marinum, M. smegmatis, and M. fortuitum are highly
susceptible to 2% alkaline glutaraldehyde, whereas others such as M. gordonae, M.
avium complex, M. xenopi, M. chelonae are resistant to it.
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Inactivation
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Inactivated by moist heat (15 minutes at 121oC) and dry heat (> 65 °C for at least 30 min) and by UV light
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Survival Outside Host
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Mycobacteria are able to survive for weeks to months on inanimate objects if protected
from sunlight. NTM species are widely distributed in nature and have been found in
natural water, tap water, soil, water used in showers and surgical solutions.
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Minimum PPE Requirements
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Lab coat, disposable gloves, safety glasses, closed toed shoes, long pants
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Additional Precautions
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Additioanl PPE may be required depending on lab specific SOPs and IBC Protocol. |