Creation of a Mitigation Plan for a Waterborne Pathogen Cluster

Session Description: This session will describe a waterborne pathogen cluster of Mycobacterium abscessus infections in a pediatric intensive care unit. A review of the current literature around M.abscessus outbreaks and clusters will be discussed as well as how water management can play into the evolution of waterborne pathogens in healthcare facilities.

A mitigation and response plan will be reviewed, including how to institute an inter-professional team to mitigate the complex response to waterborne pathogen findings. The presenter will discuss how environmental samples were collected from water sources in the intensive care unit. The session will explore the role of a water-management consultant and how they helped inform the facility’s response plan. The presenter will share how we worked with our laboratory to identify environmental growth of M.abscessus and how we utilized whole-genome sequencing to guide our decision making regarding mitigation strategies. We will identify the steps needed to send samples for whole-genome sequencing and review the results and interpretation of whole-genome sequencing to inform action items needed to prevent future waterborne infections.

The presenter will describe the immediate action plan and will further describe the long term interventions that were made to the water management plan to reduce the risk of future M.abscessus infections. The role of an ice machine and handwashing sink will be reviewed, and participants will be asked to think about their own mitigation plan should waterborne pathogens arise in their facility. The presenter will outline how these two items were mitigated and tested to mitigate the risks of future infections. The complex role water plays in a hospital setting will be showcased using a cluster of infections to tell a story about how an infection preventionist plays a part in reducing the risk of waterborne pathogens all the way from identification to long term planning.