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Transmission of Multidrug-Resistant Mycobacterium tuberculosis Among Persons Exposed in a Medical Examiner's Office, New York

Published online by Cambridge University Press:  02 January 2015

Xilla T. Ussery ,
Jennifer A. Bierman ,
Sarah E. Valway ,
Teresa A. Seitz ,
George T. DiFerdinando Jr  and
Stephen M. Ostroff
Xilla T. Ussery
Affiliation:
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Jennifer A. Bierman
Affiliation:
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Sarah E. Valway*
Affiliation:
Division of Tuberculosis Elimination, National Center for Prevention Services, Centers for Disease Control and Prevention, Atlanta, Georgia
Teresa A. Seitz
Affiliation:
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio
George T. DiFerdinando Jr
Affiliation:
New York State Department of Health, Albany, New York
Stephen M. Ostroff
Affiliation:
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Division of Tuberculosis Elimination, Mailstop E-10, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333
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Abstract

Objective:

To determine the prevalence of and risk factors for having a positive tuberculin skin test (TST) result among employees at a medical examiner's office (MEO).

Design:

Cohort study, environmental investigation.

Setting:

Several employees at a medical examiner's office were found to have positive TST results after autopsies were performed on persons with multidrug-resistant tuberculosis (MDR-TB).

Participants:

Employees of the MEO.

Results:

Of 18 MEO employees, 5 (28%) had a positive TST result; 2 of these 5 had TST conversions. We observed a trend between TST conversion and participation in autopsies on persons with MDR-TB (2 of 2 converters versus 3 of 13 employees with negative TST; relative risk=4.3; 95% confidence interval 1.61 to 11.69; P=0.l0). The environmental investigation revealed that the autopsy room was at positive pressure relative to the rest of the MEO and that air from the autopsy room mixed throughout the facility.

Conclusions:

A systematic approach to preventing transmission of Mycobacterium tuberculosis in autopsy suites should include effective environmental controls and routine tuberculin skin testing of employees.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 3 , March 1995 , pp. 160 - 165
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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