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Tejpratap S. P. Tiwari, Beverly Ray, Kenneth C. Jost, Minaxi K. Rathod, Yansheng Zhang, Barbara A. Brown-Elliott, Kate Hendricks, Richard J. Wallace, Forty Years of Disinfectant Failure: Outbreak of Postinjection Mycobacterium abscessus Infection Caused by Contamination of Benzalkonium Chloride, Clinical Infectious Diseases, Volume 36, Issue 8, 15 April 2003, Pages 954–962, https://doi.org/10.1086/368192
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Abstract
Benzalkonium chloride (BC) continues to be used as an antiseptic and contributes to serious outbreaks of disease. In July 1999, 6 postinjection joint infections caused by Mycobacterium abscessus were reported to the Texas Department of Health (Austin). We investigated this outbreak and identified 12 case patients who had been seen by the same physician and who had received an intra-articular or periarticular steroid injection during the period of 1 April through 31 July 1999. M. abscessus was cultured from either joint fluid or periarticular soft-tissue specimens obtained from 10 patients. We cultured environmental samples, and we compared isolates recovered from case patients with environmental isolates by pulsed-field gel electrophoresis and randomly amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). Four environmental samples containing diluted BC yielded M. abscessus. Clinical and environmental strains of M. abscessus were indistinguishable by RAPD-PCR. The case patients' strain was resistant to BC. The use of BC as an antiseptic should be discontinued.
- anti-infective agents, local
- disease outbreaks
- disinfectants
- dna-directed dna polymerase
- electrophoresis, gel, pulsed-field
- random amplified polymorphic dna technique
- steroids
- synovial fluid
- mycobacterium abscessus
- benzalkonium chloride
- joint infections
- soft tissue
- mycobacterium abscessus infections