caa a22 4500 388034971 CHVBK 20180307125001.0 cr unu---uuuuu 161130e199809 xx s 000 0 eng 10.1086/647889 doi S0195941700005774 pii (NATIONALLICENCE)cambridge-10.1086/647889 Nosocomial Transmission of a Drug-Sensitive W-Variant Mycobacterium tuberculosis Strain Among Patients With Acquired Immunodeficiency Syndrome in Tennessee [Elektronische Daten] Abstract Objective: To use DNA fingerprinting to characterize nosocomial spread of Mycobacterium tuberculosis following hospitalization of a patient with acquired immunodeficiency syndrome and active pulmonary tuberculosis, for whom respiratory isolation was not initiated promptly. Design: Epidemiological investigation. Setting: A tertiary-care medical center in Tennessee. Participants: Patients and healthcare workers potentially exposed to the infectious patient in 1992. Results: Of 172 healthcare workers exposed, 35 (20%) were judged to have acquired tuberculous infection. Risk of acquisition was greatest for nurses and medical receptionists. Active tuberculosis later developed in one healthcare worker and one hospitalized patient. Nosocomial transmission was supported by epidemiological evidence and DNA fingerprinting. The outbreak strain of Mycobacterium tuberculosis differed from other isolates at this hospital, but its DNA hybridization pattern was highly similar to that of the multidrug-resistant outbreak strain W that has been prevalent in New York City, suggesting a common strain ancestry. However, the Tennessee isolates were susceptible to all first-line antituberculous agents. Conclusions: This report suggests the possibility that a molecular characteristic(s) shared by these successful outbreak strains is associated with increased transmissibility or pathogenicity and emphasizes the need for continued vigilance for tuberculosis in the nosocomial setting. Copyright © The Society for Healthcare Epidemiology of America 1998 Haas David W. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Milton Scott Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Kreiswirth Barry N. The Public Health Research Institute, New York City, New York Brinsko Vicki L. The Department of Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Bifani Pablo J. The Public Health Research Institute, New York City, New York Schaffner William Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee Infection Control & Hospital Epidemiology Cambridge University Press 19/9(1998-09), 635-639 0899-823X 19:9<635 1998 19 ICE https://doi.org/10.1086/647889 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647889 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Haas David W. Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee NATIONALLICENCE 700 1- Milton Scott Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee NATIONALLICENCE 700 1- Kreiswirth Barry N. The Public Health Research Institute, New York City, New York NATIONALLICENCE 700 1- Brinsko Vicki L. The Department of Preventive Medicine, Vanderbilt University Medical Center, Nashville, Tennessee NATIONALLICENCE 700 1- Bifani Pablo J. The Public Health Research Institute, New York City, New York NATIONALLICENCE 700 1- Schaffner William Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/9(1998-09), 635-639 0899-823X 19:9<635 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge