![]() ![]() In the United States, tropical cyclones cause destructive flooding that can lead to adverse health outcomes. Clinicians and public health professionals should be aware of increased risk for NTM infections, especially in similar environments. Higher risk for NTM infection was associated with older age, rurality, and more flooding. Risk of clustering was significantly higher in rural areas (rate ratio 2.82, 95% CI 1.90–4.19) and in counties with >5 floodings per year versus no flooding (rate ratio 1.38, 95% CI 1.26–1.52). Median county-level NTM infection rate was 66.33 (interquartile range 51–91)/100,000 persons. Multilevel Poisson regression quantified small-area geographic variations and identified characteristics associated with risk for infection. Our retrospective analysis of mycobacterial cultures reported to the Missouri Department of Health and Social Services surveillance system during January 1, 2008–December 31, 2019, detected geographic clusters of infection. We describe spatial distribution of NTM infections and associations with sociodemographic factors and flooding in Missouri, USA. Nontuberculous mycobacteria (NTM) infections are caused by environmental exposure. ![]() Sustained infection prevention and control measures, adequate staffing, adhering to bed occupancy limits, and antimicrobial stewardship are key interventions to control such outbreaks. During the follow-up period, 11 new cases of CRKP infection were diagnosed we did not perform genomic analysis. Transmission network analysis identified possible index cases of bla OXA-181 ST307 in October 2019 and bla NDM-1 ST152 in November 2019. The major clone bla NDM-1 ST152 accounted for 9/14 (64%) deaths. Two outbreak-related clones ( bla NDM-1 sequence type 152 and bla OXA-181 ST307 ) cocirculated. We documented 31 cases of culture-confirmed CRKP infection and 14 deaths. We used genomic and epidemiologic data to reconstruct transmission networks of outbreak-related clones. These detections highlight risk for poliomyelitis reemergence in countries with low polio vaccine coverage.Īfter an increase in carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infections and associated deaths in the neonatal unit of a South Africa hospital, we conducted an outbreak investigation during October 2019–February 2020 and cross-sectional follow-up during March 2020–May 2021. No evidence of circulating VDPV was found the 3 isolated VDPVs were classified as ambiguous VDPVs by the international team of experts. No additional VDPV was isolated from wastewater. No AFP cases were detected in the community search institutional retrospective searches found 37% of unreported AFP cases in 2018‒2020. During the campaign, 93% of children 6 months <7 years of age received a polio-containing vaccine dose. This response was reviewed by an international expert team in July 2021. The Ministry of Health (MoH) response included event investigation through institutional and community retrospective case searches for acute flaccid paralysis (AFP) during 2018–2020 and a bivalent oral polio/measles, mumps, and rubella vaccination campaign in September 2019. Guatemala implemented wastewater-based poliovirus surveillance in 2018, and three genetically unrelated vaccine-derived polioviruses (VDPVs) were detected in 2019. ![]() We recommend using combination antimicrobial drug therapy and removal of infected devices to eradicate infection. Delays in identification and susceptibility testing were common. neoaurum was generally susceptible to multiple antimicrobial drugs and responded promptly to treatment, and infections were associated with good outcomes after relatively short therapy duration and device removal. In contrast to other mycobacteria species, M. Overall, infections were not associated with severe illness or death. ![]() Most infections occurred in young to middle-aged adults with serious underlying medical conditions and commonly involved medical devices. neoaurum bacteremia in a child with leukemia and those of 36 previously reported episodes of M. We summarize demographic and clinical characteristics of a case of catheter-related M. neoaurum infections are uncommon but likely underreported, and our understanding of the disease spectrum and optimum management is incomplete. Mycolicibacterium neoaurum is a rapidly growing mycobacterium and an emerging cause of human infections. ![]()
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