Transmission of multidrug-resistant mycobacterium tuberculosis among persons exposed in a medical examiner's office, New York.
Ussery-XT; Bierman-JA; Valway-SE; Seitz-TA; DiFerdinando-GT Jr.; Ostroff-SM
Infect Control Hosp Epidemiol 1995 Mar; 16(3):160-165
An investigation was conducted at the medical examiner's office (MEO) to assess engineering controls used to prevent transmission and to determine the extent of tuberculosis (TB) infection resulting from exposure to multidrug resistant TB (MDR/TB) during the autopsies on infected inmates. Of the 881 autopsies performed by MEO personnel during 1991, 35 (4%) were performed on inmates. Eight autopsied persons either had TB confirmed by culture prior to death or at the time of death had acid fast bacillus (AFB) smear positive specimens and were diagnosed with or were being treated for TB. All eight were inmates of state correctional institutions. Of the 18 MEO employees, five (28%) had a positive TST result. Of these, two had TST conversions. A trend was observed between TST conversion and participation in the autopsies on persons with MDR/TB. The autopsy room was at positive pressure relative to the rest of the MEO and the air from the autopsy room mixed throughout the facility. The authors conclude that a systematic approach is needed to prevent transmission of TB in autopsy suites and that this should include effective environmental controls and regular tuberculin skin testing of employees.
NIOSH-Author; Disease-control; Infectious-diseases; Ventilation-systems; Bacterial-disease; Risk-factors; Risk-analysis; Disease-vectors; Epidemiology; Health-care-personnel; Postmortem-examination
Infection Control and Hospital Epidemiology