European Society of Mycobacteriology - Instituto Nacional de Saúde ...

PP-115
Nosocomial TB in a laboratory setting
Jaime M S Nina 1,2,3
1 - Instituto Nacional de Saúde Doutor Ricardo Jorge
2 - Universidade Nova de Lisboa
3 - Hospital Egas Moniz
Abstract
TB is recognized as a major cause of morbidity and mortality worldwide. Its easily transmissibility is also generally recognized,
both at the family level, in the household, at the place of work and inside health care facilities. This last way of
transmission, properly called nosocomial transmission, has been suspected for long time, and was formally demonstrated
in the ward, both among patients, and health care workers. Several professional bodies and other institutions, both at
the national and international level, produced guidelines trying to minimize TB transmission to health care workers inside
wards and emergency services. Furthermore several countries produced legislation to protect health care workers
against nosocomial TB, and/or included TB in the list of professional diseases or hazards to health care workers.
However, much less attention has been given to the TB transmission potential to laboratory workers. Even if several
countries moved laboratory work with live TB samples to LSB-3 facilities, the evidence on which to base this decision is
thin, and no systematic study has been published.
Herein are presented three cases of nosocomial transmission inside laboratory settings, in Lisbon. These cases cover all
spectra of professional differentiation, from basic level auxiliary personnel, to a laboratory technician, and to a microbiologist
physician. In one case the way of transmission was a very common kind of laboratory accident, in another a
common inattention, and in the last one no specific way of transmission was found. One of the cases was found to be a
MDX TB.
In conclusion, the trend to carry out all routine work with live TB samples only inside a BSL-3 facility seems a right one,
and so it is fully justified. Also justified would be the inclusion of health laboratory workers in the legislation that provide
safety measures and insurance cover to health care workers.
European Society of Mycobacteriology | 30 th Annual Congress | July 2009 | Porto - Portugal
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