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AWWA ACE68639

AWWA ACE68639 The Efficacy of Chlorine Disinfectants on Rapidly Growing Mycobacteria

Conference Proceeding by American Water Works Association, 11/01/2008

Williams, Margaret M.; Bonkosky-Medina, Michelle; Santana, Angely; Carr, Janice H.; Rose, Laura J.; Donlan, Rodney M.; Arduino, Matthew J.

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This powerpoint presentation begins by providing a brief overview of the issue of rapidly growingmycobacteria (RGM), and presents an investigation of an outbreak of M abscessus in a long term carefacility. Specifics of the outbreak investigation included:M. abscessus infections in ventilator patients; epidemiology suggested water supply as thesource of infection;water testing recovered other RGM, not M.abscessus (M chelonae, M peregrinum, M mucogenicum,unidentified species recovered from multiple faucets over severalsamplings). Treatment measures included:hyperchlorination, 40 ppm hypochlorite;point-of-use filters, Pall Corporation;filters installed on four sink faucets; and,water examined for HPC (heterotrophicplate count) bacteria and RGM (rapidlygrowing mycobacteria). The actual laboratory study of chlorinedisinfection of M abscessus BiofilmFree Chlorine, pH 7 is presented, with results of M abscessus biofilm grown in drinking water indicating:cord formation increases chlorinesusceptibility; and,mycobacteria biofilm tolerates "normal"chlorine residual. Presentation conclusions indicate that: chlorine does not control RGM inhealthcare water systems;point-of-use treatment may be bestpreventive measure; and,improvements needed for RGMdetection and isolation methods. Includes tables, figures.

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