DE Griffith, JL Hardeman, Y Zhang, RJ Wallace and GH Mazurek
Department of Medicine, University of Texas Health Center at Tyler 75710, USA.

Twenty-nine healthcare workers (HCW) were exposed to an active case of unrecognized drug-susceptible pulmonary tuberculosis in a community hospital for as long as 2 h in the emergency room and 10 h in a medical intensive care unit. Twelve of the 29 exposed HCW could not be evaluated for tuberculosis infection because 10 of them had a previously positive tuberculin skin test and two were lost to follow- up. Of the remaining 17 tuberculin skin test negative HCW, 13 (76%) either converted their skin test to positive (10 HCW) or developed active disease (three HCW) after exposure to the index case. The Mycobacterium tuberculosis isolates from the three HCW had identical DNA restriction fragment length polymorphism (RFLP) patterns when studied by pulsed field gel electrophoresis. This case of drug- susceptible tuberculosis was associated with unusually high rates of tuberculosis infection and disease in HCW. Prevention of similar occurrences in HCW may be difficult because of the short exposure time required for transmission of tuberculosis and the absence of consensus on optimal respiratory protective measures.

This article has been cited by other articles:

				E. Curran, P. Hoffman, and R. Pratt Tuberculosis and infection control: a review of the evidence British Journal of Infection Control, April 1, 2006; 7(2): 18 - 23. [Abstract] [PDF]

				C. Greenaway, D. Menzies, A. Fanning, R. Grewal, L. Yuan, J. M. FitzGerald, and The Canadian Collaborative Group in Nosocomial Tra Delay in Diagnosis among Hospitalized Patients with Active Tuberculosis-Predictors and Outcomes Am. J. Respir. Crit. Care Med., April 1, 2002; 165(7): 927 - 933. [Abstract] [Full Text] [PDF]

				G. Cappelli, P. Volpe, A. Sanduzzi, A. Sacchi, V. Colizzi, and F. Mariani Human Macrophage Gamma Interferon Decreases Gene Expression but Not Replication of Mycobacterium tuberculosis: Analysis of the Host-Pathogen Reciprocal Influence on Transcription in a Comparison of Strains H37Rv and CMT97 Infect. Immun., December 1, 2001; 69(12): 7262 - 7270. [Abstract] [Full Text] [PDF]

				K. G. Dobbs, K. H. Lok, F. Bruce, D. Mulcahy, W. H. Benjamin, and N. E. Dunlap Value of Mycobacterium tuberculosis Fingerprinting as a Tool in a Rural State Surveillance Program Chest, December 1, 2001; 120(6): 1877 - 1882. [Abstract] [Full Text] [PDF]

				J. E. Golub, W. A. Cronin, O. O. Obasanjo, W. Coggin, K. Moore, D. S. Pope, D. Thompson, T. R. Sterling, S. Harrington, W. R. Bishai, et al. Transmission of Mycobacterium tuberculosis Through Casual Contact With an Infectious Case Arch Intern Med, October 8, 2001; 161(18): 2254 - 2258. [Abstract] [Full Text] [PDF]

				R. R. Demers Bacterial/Viral Filtration : Let the Breather Beware! Chest, October 1, 2001; 120(4): 1377 - 1389. [Abstract] [Full Text] [PDF]

				C. Manca, L. Tsenova, C. E. Barry III, A. Bergtold, S. Freeman, P. A. J. Haslett, J. M. Musser, V. H. Freedman, and G. Kaplan Mycobacterium tuberculosis CDC1551 Induces a More Vigorous Host Response In Vivo and In Vitro, But Is Not More Virulent Than Other Clinical Isolates J. Immunol., June 1, 1999; 162(11): 6740 - 6746. [Abstract] [Full Text] [PDF]

				S. E. Valway, M. P. C. Sanchez, T. F. Shinnick, I. Orme, T. Agerton, D. Hoy, J. S. Jones, H. Westmoreland, and I. M. Onorato An Outbreak Involving Extensive Transmission of a Virulent Strain of Mycobacterium tuberculosis N. Engl. J. Med., March 5, 1998; 338(10): 633 - 639. [Abstract] [Full Text] [PDF]