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Mycobacterium tuberculosis Specimen Contamination Revisited: The Role of Laboratory Environmental Control in a Pseudo-outbreak

Published online by Cambridge University Press:  02 January 2015

Sorana Segal-Maurer ,
Barry N. Kreiswirth ,
Janice M. Burns ,
Sol Lavie ,
Mimi Lim ,
Carl Urban  and
James J. Rahal Jr
Sorana Segal-Maurer*
Affiliation:
Division of Infectious Diseases, the Department of Medicine, New York City, New York Department of New York Hospital Medical Center of Queens, Flushing, New York; and the Medicine, New York City, New York
Barry N. Kreiswirth
Affiliation:
Cornell University Medical College, Public Health Research Institute, Tuberculosis Center, New York City, New York
Janice M. Burns
Affiliation:
Department of Nursing, New York City, New York
Sol Lavie
Affiliation:
Department of Pathology, Microbiology Laboratory, New York City, New York
Mimi Lim
Affiliation:
Department of Nursing, New York City, New York
Carl Urban
Affiliation:
Division of Infectious Diseases, the Department of Medicine, New York City, New York Microbiology, New York City, New York
James J. Rahal Jr
Affiliation:
Division of Infectious Diseases, the Department of Medicine, New York City, New York Department of New York Hospital Medical Center of Queens, Flushing, New York; and the Medicine, New York City, New York
*
Division of Infectious Diseases, New York Hospital Medical Center of Queens, 56-45 Main St, Flushing, NY 11355
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Abstract

Objective:

To investigate suspected pseudo-outbreaks of Mycobacterium tuberculosis (MTB) during August 1994 and July 1995 among patients who did not have clinical findings consistent with tuberculosis.

Design:

Retrospective and prospective surveys of all clinical and laboratory data using standard epidemiological tools and DNA fingerprinting.

Setting:

A university-affiliated community hospital.

Patients:

Those with positive MTB cultures during periods when we noted that the number of MTB positive cultures greatly outnumbered the usual monthly average (retrospective analysis, 1994) and patients with positive MTB cultures without clinical findings consistent with tuberculosis (prospective survey, 1995).

Results:

Epidemiological and molecular studies revealed specimen cross-contamination in the laboratory due to a faulty exhaust hood. Improvement in laboratory ventilation and change of the implicated hood prevented further specimen contamination.

Conclusions:

The identification of positive MTB cultures from patients without clinical evidence of tuberculosis should be a signal to suspect laboratory contamination and implement control measures. These should include a thorough epidemiological investigation, DNA fingerprint analysis, and an environmental inspection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 2 , February 1998 , pp. 101 - 105
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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