Medical Sterile Standards and Infection Control News

October 17, 2019

IntraSpace will regularly bring you the latest information in regards to compliance with the AS4187 Sterile Standards and news about the topic of infection control. Don’t put your patient’s at risk! Stay informed and speak to us about helping you comply today.

Buruli Ulcer (Mycobacterium ulcerans)

Since 2013, Australia has noted a significant increase in notifications of the Buruli Ulcer; a chronic debilitating infection, causing soft-tissue destruction.

Buruli Ulcer is caused by an environmental pathogen Mycobacterium ulcerans.  M. ulcerans belong to the family of organisms that cause tuberculosis and leprosy. Presentation of infection occurs as a non-tender lump that can present similarly to an insect bite in lieu of often being itchy and most commonly it occurs on an exposed limb predominantly around the joints. Ulceration commences approximately 4-8 weeks post appearing, whereby the mycolactone toxin that the bacteria produces causes tissue damage. The ulceration can spread and cause significant tissue loss which can then lead to permanent disfigurement.

Reports of this disease within Australia have risen from 66 cases (2013) to 358 case (2018) with presentation mostly noted in Far North Queensland and parts of Coastal Victoria. The method of transmission remains unclear however a major risk factor includes exposure to contaminated environments such as water or soil. The bacteria may enter through broken skin, and both mosquitoes and some water-dwelling insects have been implicated in the transmission pathway. Most cases report some form of skin trauma prior to the development of the lesion.

Swabs of ulcerated tissue should be taken for culture and PCR as well as tissue biopsy to identify M. ulcerans. Treatment typically entails combination of antimicrobials and wide surgical excision of infected tissue. Infected tissue should be managed with Standard Precautions with ulcers to be covered. Under the Public Health and Wellbeing Regulations 2009, Buruli ulcer is a Group B disease and therefore must be notified in writing by medical practitioners within five days of diagnosis.