A cluster of acinetobacter pneumonia in foundry workers.
Cordes-LG; Brink-EW; Checko-PJ; Lentnek-A; Lyons-RW; Hayes-PS; Wu-TC; Tharr-DG; Fraser-DW
Ann Intern Med 1981 Dec; 95(6):688-693
A cluster of cases of pneumonia and sepsis occurring in three workers in a steel casting foundry was presented. The disease was caused by Acinetobacter-calcoaceticus variety anitratus. Bacterial cultures, serology samples, and environmental samples were obtained from workers and the worksite; serology results were compared with those of workers from another foundry and those of a referent group. The first case involved a 54 year old man who worked as a castings grinder and chipper for 5 years. Antemortem sputum and blood and postmortem lung tissue grew A-calcoaceticus variety anitratus. Lung tissue showed widespread bronchopneumonia with consolidation. Evidence was noted of mixed dust pneumoconiosis with one nodule suggestive of silicosis. The second patient was a 63 year old man who had been a castings grinder and chipper for 13 years. His diagnosis indicated pneumonia which rapidly progressed during therapy with penicillin but which responded to the combination of gentamicin and carbenicillin. The third patient was a 56 year old man who had been a welder for 19 years. He had had another episode of pneumonia in the previous 5 years, as had the first patient. His Acinetobacter pneumonia and septicemia progressed despite appropriate antibiotic therapy. Mixed dust pneumoconiosis was diagnosed, and it was thought that an associated Aspergillus infection may have complicated therapy. These workers had been exposed to unacceptably high levels of total particulates, free silica (7631869), and metallic dusts. The 7J serotype responsible for the disease was only isolated in cafeteria air sampling; a few environmental samples were positive for other serotypes. Raised serum antibody titers to A-calcoaceticus variety anitratus were present in about 15 percent of workers in each foundry and in only about 2 percent of community referents. The authors conclude that chronic exposure to metallic and silica particles may increase susceptibility to infection by this organism.
NIOSH-Author; Pulmonary-system-disorders; Foundry-workers; Lung-disorders; Bacterial-disease; Infectious-diseases; Disease-transmission; Metal-fumes; Steel-industry; Steel-foundries; Welding-industry; Dust-inhalation
Annals of Internal Medicine