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Is domestic tap water a risk for infections in neutropenic patients?

机译：家用自来水是否有中性粒细胞减少症患者感染的风险？

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BACKGROUND: Home care has become popular in the management of hemato-oncologic patients. Therefore, we conducted a prospective study to assess whether tap water from the domestic environment of neutropenic patients poses a risk for infections from the waterborne pathogens nontuberculous mycobacteria (NTM), Legionella spp., and Pseudomonas aeruginosa. MATERIALS AND METHODS: Tap water samples were taken in the homes of 65 hemato-oncologic patients who were discharged from the hospital whilst neutropenic and had a suspected period of neutropenia of a minimum of 10 days. Selective culture for Legionella, P. aeruginosa, and NTM was performed. Patients who required hospital readmission were monitored for infection with the aforementioned pathogens over the following 3 months. RESULTS: NTM were cultured in 62 (95.4%) households in concentrations from 1 to 1,000 CFU/500 ml. The facultative pathogenic species Mycobacterium chelonae (58.5% of taps) and M. mucogenicum (38.5% of taps) were most frequently detected. Legionella spp. was cultured from six households (9.2%), including five households with L. pneumophila in concentrations from 25 to 2,500 CFU/500 ml. P. aeruginosa was found in seven households (10.8%) in concentrations from 5 to 2,500 CFU/500 ml. While clinical infection with Legionella spp. was not detected in any patients, infection with M. chelonae and P. aeruginosa occurred in one and seven patients, respectively. However, transmission from household water could not be confirmed. CONCLUSION: Although the risk of infection from household water-borne pathogens appears low, preventive measures may be considered on an individual basis in patients with long-term immunosuppression as well as in patients with long-term central-vascular catheterization.
机译：背景：家庭护理已在血液肿瘤患者的治疗中流行。因此，我们进行了一项前瞻性研究，以评估来自嗜中性白血球减少症患者家庭环境中的自来水是否存在水传播病原体非结核分枝杆菌（NTM），军团菌和铜绿假单胞菌感染的风险。材料与方法：自来水样本取自65名血液肿瘤患者，他们在中性粒细胞减少的同时出院，并且怀疑中性粒细胞减少的时间至少为10天。进行了军团菌，铜绿假单胞菌和NTM的选择性培养。在接下来的3个月中，对需要再次入院的患者进行了上述病原体感染的监测。结果：NTM在62个（95.4％）家庭中以1至1,000 CFU / 500 ml的浓度进行培养。最常检测到兼性的致病性物种，即分枝杆菌分枝杆菌（分枝的58.5％）和粘液分枝杆菌（分枝的38.5％）。军团菌属从六个住户（9.2％）中培养了该菌，其中五个住户的肺炎嗜血杆菌浓度为25至2,500 CFU / 500 ml。铜绿假单胞菌在7户（10.8％）的浓度为5至2,500 CFU / 500 ml。而临床上有军团菌属感染。在任何患者中均未检出，分别有1例和7例患者感染了chelonae和铜绿假单胞菌。但是，无法确认从家庭用水传播。结论：尽管家庭携带的水传播病原体感染的风险似乎较低，但对于长期免疫抑制的患者以及长期进行中枢血管插管的患者，可以单独考虑采取预防措施。

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