Response to an Outbreak of Mycobacterium Abscessus Infection Related to Aesthetic Procedures in a Dental Clinic

Cases of infection by rapidly growing mycobacteria (RGM) associated with aesthetic procedures have increased over recent years. The objective of this work is to describe the coordinated response of CIEVS to an outbreak of Mycobacterium abscessus infection associated with submental liposuction performed in a dental clinic, focusing on the surveillance, prevention, and control actions implemented to mitigate collective risk. Descriptive study based on document analysis and an anonymized database of outbreak investigation of RGM associated with a healthcare facility, from December 2023 to December 2024. After notification of the first case, in December 2023, actions were immediately articulated with epidemiological and sanitary surveillance, the care network, the reference laboratory, and partner technical institutions. A risk analysis was performed and operational guidelines were prepared based on national protocols and scientific evidence. Coordinated actions included defining case criteria, organizing notification, investigation, and clinical management flows, producing guidance materials, and providing technical support for sanitary actions. The investigation identified 32 patients with skin lesions (erythema, nodules, pain, secretion, and fistulas) after procedures performed between December 2023 and February 2024 in a single dental clinic. Of these, 18 lived in the same municipality where the clinic was located. There was a need for prolonged specific antibiotic therapy and, in some cases, surgical intervention. Fifteen patients had laboratory confirmation for M. abscessus . As a sanitary measure, the clinic was inspected and interdicted by the municipal Health Surveillance. Criteria were applied to characterize the environment as controlled, aiming at the safe demobilization of the measures adopted. The technical, articulated, and timely performance of the involved institutions was essential to conduct the response to the RGM outbreak, enabling rapid intersectoral articulation, risk mitigation, and population protection. The event reinforces the need for vigilant surveillance of this type of infection associated with aesthetic procedures, as well as the importance of the strategic roles of CIEVS in the coordinated response to events of this nature.