{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:01:01Z","timestamp":1785420061466,"version":"3.56.0"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,4]]},"abstract":"Abstract<\/jats:title>\n \n Objective:<\/jats:title>\n \n To report on the investigation of a pseudo-outbreak of\n Mycobacterium mucogenicum<\/jats:italic>\n and examine its clinical and operational impact.\n <\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Outbreak investigation, retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Academic medical center in Los Angeles, California.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n \n Patients whose bronchoalveolar lavage (BAL) cultures grew\n M. mucogenicum<\/jats:italic>\n from 2020\u20132024.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n We performed an institutional outbreak investigation of\n M. mucogenicum<\/jats:italic>\n , reviewed electronic medical records of a subset of affected patients (2023\u20132024), and assessed the operational impact.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The incidence of\n M. mucogenicum<\/jats:italic>\n in BAL cultures at Hospital A increased from 6.1% (29\/473) in 2020 to 18.6% (29\/156) in the first quarter of 2024. Epidemiologic investigation revealed non-sterile ice baths used to cool uncapped sterile syringes during bronchoscopy procedures as the contamination source. Next generation sequencing linked clinical isolates to\n M. mucogenicum<\/jats:italic>\n recovered from a perioperative ice machine. Nearly all (157\/160) clinical isolates grew from nocardia media rather than acid-fast bacilli media. Among 154 patients, including 51 (33.1%) who were highly immunocompromised, no true infections were identified. Thirty-nine (25.3%) patients were referred to infectious diseases for consultation, seven (4.5%) underwent additional workup, and only one received targeted treatment. The pseudo-outbreak incurred 458 hours of microbiology technologist and infection preventionist time and cost the laboratory $88,426.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n A four-year pseudo-outbreak of\n M. mucogenicum<\/jats:italic>\n traced to contaminated ice baths used during bronchoscopy resulted in unnecessary infectious disease referrals and substantial operational and financial burden to the institution. Avoidance of non-sterile ice use in procedures prevents costly and burdensome pseudo-outbreaks of environmental mycobacteria in healthcare settings.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/ice.2026.10399","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T08:18:21Z","timestamp":1770625101000},"page":"379-385","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and operational impact of a four-year-long bronchoscopy-associated pseudo-outbreak of\n Mycobacterium mucogenicum<\/i>"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3315-629X","authenticated-orcid":false,"given":"Kavitha","family":"Prabaker","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d88se56","id-type":"ROR","asserted-by":"publisher"}],"name":"UCLA Health"},{"id":[{"id":"https:\/\/ror.org\/046rm7j60","id-type":"ROR","asserted-by":"publisher"}],"name":"David Geffen School of Medicine at UCLA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0455-3281","authenticated-orcid":false,"given":"Ran","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2485-3927","authenticated-orcid":false,"given":"Sanchi","family":"Malhotra","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d88se56","id-type":"ROR","asserted-by":"publisher"}],"name":"UCLA Health"},{"name":"David Geffen School of Medicine at UCLA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9991-1178","authenticated-orcid":false,"given":"Shangxin","family":"Yang","sequence":"additional","affiliation":[{"name":"UCLA David Geffen School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colette","family":"Match","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3438-8023","authenticated-orcid":false,"given":"Sebora","family":"Turay","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d88se56","id-type":"ROR","asserted-by":"publisher"}],"name":"UCLA Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Bluntson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d88se56","id-type":"ROR","asserted-by":"publisher"}],"name":"UCLA Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaunte","family":"Walton","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d88se56","id-type":"ROR","asserted-by":"publisher"}],"name":"UCLA Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Dogan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d88se56","id-type":"ROR","asserted-by":"publisher"}],"name":"UCLA Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9800-3482","authenticated-orcid":false,"given":"Daniel","family":"Uslan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d88se56","id-type":"ROR","asserted-by":"publisher"}],"name":"UCLA Health"},{"id":[{"id":"https:\/\/ror.org\/046rm7j60","id-type":"ROR","asserted-by":"publisher"}],"name":"David Geffen School of Medicine at UCLA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"S0899823X26103997_ref11","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.02476-07"},{"key":"S0899823X26103997_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2019.317"},{"key":"S0899823X26103997_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(87)90121-0"},{"key":"S0899823X26103997_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.101"},{"key":"S0899823X26103997_ref21","unstructured":"21. Bancroft, J , Shih, DS , Cassidy, MP , et\u00a0al. Council of State and Territorial Epidemiologists position statement 17-ID-07: standardized case definition for extrapulmonary nontuberculous\u00a0Mycobacteria\u00a0infections. Atlanta, GA: Council of State and Territorial Epidemiologists; 2017."},{"key":"S0899823X26103997_ref1","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.65.6.2492-2496.1999"},{"key":"S0899823X26103997_ref22","doi-asserted-by":"publisher","DOI":"10.7326\/M22-3306"},{"key":"S0899823X26103997_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2017.321"},{"key":"S0899823X26103997_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2008.07.016"},{"key":"S0899823X26103997_ref16","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00190"},{"key":"S0899823X26103997_ref5","doi-asserted-by":"publisher","DOI":"10.1086\/668021"},{"key":"S0899823X26103997_ref2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.micro.52.1.453"},{"key":"S0899823X26103997_ref3","doi-asserted-by":"publisher","DOI":"10.1086\/502341"},{"key":"S0899823X26103997_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.5"},{"key":"S0899823X26103997_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2023.106726"},{"key":"S0899823X26103997_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2023.08.007"},{"key":"S0899823X26103997_ref7","doi-asserted-by":"publisher","DOI":"10.1086\/591451"},{"key":"S0899823X26103997_ref13","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2014.28"},{"key":"S0899823X26103997_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.660"},{"key":"S0899823X26103997_ref20","unstructured":"20. Considerations for Reducing Risk: Water in Healthcare Facilities. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/healthcare-associated-infections\/php\/toolkit\/water-management.html Published 2024. Accessed September 18, 2025."},{"key":"S0899823X26103997_ref15","doi-asserted-by":"publisher","DOI":"10.1086\/340741"},{"key":"S0899823X26103997_ref18","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01519-18"}],"container-title":["Infection Control & Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26103997","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T03:06:22Z","timestamp":1776999982000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26103997\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["S0899823X26103997"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10399","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}