{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:45:57Z","timestamp":1792118757545,"version":"4.4.0"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X25103449_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      Investigate the increased incidence of\n                      <jats:italic>Mycobacterium chelonae<\/jats:italic>\n                      positive respiratory cultures in hospitalized patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103449_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>\n                      Apply the Healthcare-Associated Links in Transmission of Nontuberculous Mycobacteria (HALT NTM) toolkit to an outbreak investigation of\n                      <jats:italic>M. chelonae.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103449_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Quaternary-care pediatric hospital and medical center in the United States with a recently opened LEED-certified critical care tower.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103449_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>\n                      Adult and pediatric patients with\n                      <jats:italic>M. chelonae<\/jats:italic>\n                      positive respiratory cultures between June 2022 and January 2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103449_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      An epidemiological investigation involving clinical and laboratory practices, water management, building construction and renovation projects. Environmental sampling of air vents, water sources and endoscope reprocessing equipment was performed.\n                      <jats:italic>M. chelonae<\/jats:italic>\n                      isolates recovered from patients and the environment were analyzed using whole genome sequencing and compared for relatedness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103449_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Three clusters of matching environmental and patient isolates were identified. The most common environmental source of\n                      <jats:italic>M. chelonae<\/jats:italic>\n                      was ice\/water dispensers with 40% positivity of sampled units. The critical care tower\u2019s water system performance and metrics were suboptimal, leading to four physical remediation activities along with a hyperchlorination treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X25103449_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Recent and ongoing construction along with the implementation of a LEED-certified, low-flow water system in a new critical care tower provided enhanced opportunities for\n                      <jats:italic>M. chelonae<\/jats:italic>\n                      exposure at point of use locations such as ice\/water dispensers. More national infection prevention and control guidance is needed to address the infection risks from water sustainability efforts and construction activities in healthcare facilities.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2025.10344","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T08:53:26Z","timestamp":1763974406000},"page":"161-169","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["<i>Mycobacterium chelonae<\/i>\n                    outbreak investigation at a quaternary pediatric hospital following the opening of a LEED-certified critical care tower: where does water sustainability intersect with infection control?"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9599-564X","authenticated-orcid":false,"given":"Andrea L.","family":"Ankrum","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01hcyya48","id-type":"ROR","asserted-by":"publisher"}],"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia M.","family":"Caceres","sequence":"additional","affiliation":[{"name":"National Jewish Health"},{"name":"University of North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Torsell","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01hcyya48","id-type":"ROR","asserted-by":"publisher"}],"name":"Cincinnati Children\u2019s Hospital Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Epperson","sequence":"additional","affiliation":[{"name":"National Jewish Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5874-0958","authenticated-orcid":false,"given":"Vinicius","family":"Calado Nogueira de Moura","sequence":"additional","affiliation":[{"name":"National Jewish Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J.","family":"Gilick","sequence":"additional","affiliation":[{"name":"National Jewish Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-6260","authenticated-orcid":false,"given":"Michael","family":"Strong","sequence":"additional","affiliation":[{"name":"National Jewish Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyun","family":"Liu","sequence":"additional","affiliation":[{"name":"University of North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9083-5989","authenticated-orcid":false,"given":"Matthew J.","family":"Strand","sequence":"additional","affiliation":[{"name":"National Jewish Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel N.","family":"Wilsey","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Tyler"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4943-8738","authenticated-orcid":false,"given":"Jennifer R.","family":"Honda","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Tyler"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E.","family":"Gross","sequence":"additional","affiliation":[{"name":"National Jewish Health"},{"name":"University of North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-6208","authenticated-orcid":false,"given":"Felicia A.","family":"Scaggs-Huang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01hcyya48","id-type":"ROR","asserted-by":"publisher"}],"name":"Cincinnati Children\u2019s Hospital Medical Center"},{"name":"Cincinnati Children\u2019s Hospital Medical Center"},{"name":"University of Cincinnati College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"S0899823X25103449_ref34","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.67.3.1225-1231.2001"},{"key":"S0899823X25103449_ref37","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1237"},{"key":"S0899823X25103449_ref14","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9020224"},{"key":"S0899823X25103449_ref26","unstructured":"26. 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