Background: The Surgical site infections (SSI’s) put up to nearly 20% of all the Healthcare associated infections (HAI). Atypical mycobacteria have been known to colonize in water and soil and can therefore easily contaminate solutions, instruments and disinfectants used in hospital settings. Erroneous cleaning, disinfection and sterilization of laparoscopic instruments is predominantly responsible for such outbreaks.
Material and methods: Clinical suspicion by the surgeons of DRPGMC, Tanda of atypical mycobacterial infection from non-healing wounds after laparoscopic surgery was raised to the Infection control team. Pus samples from non healing ulcer sites, environmental and laproscope samples were collected and processed as per the standard guidelines.
Results: Out of 7 postoperative patients with non healing ulcers, 5 showed Acid fast bacilli (AFB) on Ziehl-Neelsen (ZN) staining. Out of these 5 samples only 3 were culture positive showing growth of LJ media slant and blood agar within 7 to 10 days of incubation at 37°C. Samples from laparoscopic lumen and reusable ports on ZN staining showed Acid fast bacilli. Similarly growth was obtained within 7-10 days from reusable ports on LJ media. On molecular diagnosis Mycobacterium abscessus was confirmed from the reusable port.
Conclusion: Nontuberculous Mycobacterial infections in post operative wounds though rare but should be suspected in all postoperative wound infections which occur late, lack local and systemic signs of pyogenic infections and have sterile cultures. Guidelines for strict sterilization procedures of laparoscopic instruments should be followed.