Context. - An ongoing restriction fragment length polymorphism (RFLP) study of Mycobacterium tuberculosis isolates from tuberculosis (TB) cases revealed an identical 10-banded IS6110 RFLP pattern unique to 2 patients diagnosed as having TB 6 months apart.
Their only identifiable link was care at the same hospital.
To determine if nosocomial transmission had occurred.
- Traditional and molecular epidemiologic investigation.
- We reviewed medical charts and bronchoscopic records, examined hospital locations visited by both patients, evaluated hospital ventilation systems, and observed cleaning and disinfection of bronchoscopes.
- A patient with cough, hoarseness, and fever underwent bronchoscopy and was diagnosed as having TB.
A second patient with a mediastinal mass underwent bronchoscopy 2 days later and was diagnosed as having small cell carcinoma.
Following 6 months of chemotherapy and radiation therapy, the second patient developed fever and an infiltrate of the right upper lobe of the lung.
Bronchoscopic washings revealed acid-fast bacilli and were culture positive for M tuberculosis.
Both patients had undergone bronchoscopy with the same instrument in the same operating room with no intervening bronchoscopies.
Bronchoscope cleaning and disinfection procedures were inconsistent with national guidelines. (...)
Mots-clés Pascal : Infection nosocomiale, Facteur risque, Contamination mécanique, Bronchoscope, Fibre optique, Identification, Mycobacterium tuberculosis, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bactérie, Epidémiologie, Prévention, Homme, Etats Unis, Amérique du Nord, Amérique, Infection, Traitement instrumental, Mycobactériose, Bactériose
Mots-clés Pascal anglais : Nosocomial infection, Risk factor, Mechanical contamination, Bronchoscop, Optical fiber, Identification, Mycobacterium tuberculosis, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bacteria, Epidemiology, Prevention, Human, United States, North America, America, Infection, Instrumentation therapy, Mycobacterial infection, Bacteriosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0515322
Code Inist : 002B05B02O. Création : 13/02/1998.