Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-21T13:47:10.350Z Has data issue: false hasContentIssue false
  • English
  • Français

Cross-Contamination with Mycobacterium tuberculosis: An Epidemiological and Laboratory Investigation

Published online by Cambridge University Press:  02 January 2015

Beth Nivin ,
Paula I. Fujiwara ,
John Hannifin  and
Barry N. Kreiswirth
Beth Nivin*
Affiliation:
Bureau of Tuberculosis Control, New York City Department of Health, New York, New York
Paula I. Fujiwara
Affiliation:
Bureau of Tuberculosis Control, New York City Department of Health, New York, New York Division of Tuberculosis Elimination, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
John Hannifin
Affiliation:
Bureau of Tuberculosis Control, New York City Department of Health, New York, New York
Barry N. Kreiswirth
Affiliation:
Public Health Research Institute, Centers for Disease Control and Prevention, Atlanta, Georgia
*
225 Broadway, Box 72B, New York, NY 10007
Get access Rights & Permissions [Opens in a new window]

Abstract

OBJECTIVE:

To investigate possible cross-contamination of laboratory specimens, as suggested by an increased incidence of newly diagnosed patients with tuberculosis, many of whom had all negative smears for acid-fast bacilli and only one positive Mycobacterium tuberculosis culture referred to as “negative smears, one positive” or NSOP.

METHODS:

Medical-record reviews were performed for all patients with NSOP results diagnosed at this facility within a 9-month period. Laboratory logbooks were reviewed for all isolates processed; DNA fingerprinting was performed on available isolates.

RESULTS:

Of 80 patients with NSOP results, 45 (56%) were found to have false-positive cultures resulting from laboratory contamination with H37Ra, an avirulent stock strain of Mycobacterium tuberculosis.

CONCLUSION:

Laboratory cross-contamination resulted in the false diagnosis of tuberculosis in at least 45 individuals. Use of the Mycobacteria Growth Indicator Tube may have contributed to these contamination incidents by detecting small numbers of contaminating mycobacteria that may not have been detected with less sensitive media.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 7 , July 1998 , pp. 500 - 503
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Aber, VR, Allen, BW, Mitchison, DA, Ayuma, P, Edwards, EA, Keyes, AB. Quality control in tuberculosis bacteriology, 1: laboratory studies on isolated positive cultures and efficiency of direct smear examination. Tubercle 1980;61:123–133.Google Scholar
2.Braden, CR, Templeton, GL, Stead, WS, Bates, JH, Cave, MD, Valway, SE. Retrospective detection of laboratory cross-contamination of Mycobacterium tuberculosis cultures with use of DNA fingerprint analysis. Clin Infect Dis 1997;24:35–40.Google Scholar
3.Conville, PS, Witebsky, FG. Inter-bottle transfer of mycobacteria by the BACTEC 460. Diagn Microbiol Infect Dis 1989;12:401–405.Google Scholar
4.Frieden, TR, Woodley, CL, Crawford, JT, Lew, D, Dooley, SM. The molecular epidemiology of tuberculosis in New York City: the importance of nosocomial transmission and laboratory error. Tubercle and Lung Disease 1996;77:407–413.Google Scholar
5.Mauer, JR, Desmond, EP, Lesser, MD, Jones, WD. False positive cultures of Mycobacterium tuberculosis. Chest 1984;86:439–443.Google Scholar
6.Mitchison, DA, Keyes, AB, Edwards, EA, Ayuma, P, Byfield, SP, Nunn, AJ. Quality control in tuberculosis bacteriology, 2: the origin of isolated positive cultures from the sputum of patients in four studies of short course chemotherapy in Africa. Tubercle 1980;61:135–144.Google Scholar
7.Murray, PR. Mycobacterial cross-contamination with the modified BACTEC 460 TB system. Diagn Microbiol Infect Dis 1991;14:33–35.Google Scholar
8.Salfinger, M. Role of the laboratory in evaluating patients with mycobacterial disease. Clinical Microbiology Newsletter 1995;17:14.Google Scholar
9.Wurtz, R, Demarais, P, Trainor, W, McAuley, J, Kocka, F, Mosher, L, et al.Specimen contamination in mycobacteriology laboratory detected by pseudo-outbreak of multidrug-resistant tuberculosis: analysis by routine epidemiology and confirmation by molecular technique. J Clin Microbiol 1996;34:1017–1019.Google Scholar
10.Burman, WJ, Stone, BL, Reves, RR, Wilson, ML, Yang, Z, El-Hajj, H, et al.The incidence of false-positive cultures for Mycobacterium tuberculosis. Am J Respir Crit Care Med 1997;155:321–326.Google Scholar
11.van Embden, JDA, Cave, MD, Crawford, JT, Dale, JW, Eisenach, KD, Gicquel, B, et al.Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a standardized methodology. J Clin Microbiol 1993;31:406–409.Google Scholar
12.Kent, PT, Kubica, GP. Public Health Mycobacteriology—A Guide for the Level III Laboratory. Atlanta, GA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 1985.Google Scholar
13.Centers for Disease Control and Prevention. Mycobacterium tuberculosis—assessing your laboratory. Atlanta, GA: CDC; 1995.Google Scholar
14.Dunlap, NE, Harris, RH, Benjamin, WH, Harden, JW, Hafner, D. Laboratory contamination of Mycobacterium tuberculosis cultures. Am J Respir Crit Care Med 1995;152:1702–1704.Google Scholar
15.Vannier, AM, Tarrand, JJ, Murray, PR. Mycobacterial cross contamination during radiometric culturing. J Clin Microbiol 1988;26:1867–1868.Google Scholar
16.Fischl, MA, Uttamchandani, RB, Daikos, GL, Poblete, RB, Moreno, JN, Reyes, RR, et al.An outbreak of tuberculosis caused by multiple-drug-resistant tubercle bacilli among patients with HIV infection. Ann Intern Med 1992;117:177–182.Google Scholar
17.Valway, S, Dooley, S, Ikeda, R, Jereb, J, Kent, J, Onorato, I. False positive diagnosis of multidrug resistant tuberculosis due to laboratory contamination. Tuber Lung Dis 1994;75:S42. Abstract.Google Scholar
18.MacGregor, RR, Clark, LW, Bass, F. The significance of isolating low numbers of Mycobacterium tuberculosis in culture of sputum specimens. Chest 1975;68:518–523.Google Scholar
19.Small, PM, McClenny, NB, Singh, SP, Schoolnik, GK, Tomkins, LS, Mickelsen, PA. Molecular strain typing of Mycobacterium tuberculosis to confirm cross-contamination in the mycobacteriology laboratory and modification of procedures to minimize occurrence of false-positive cultures. J Clin Microbiol 1993;31:1677–1682.Google Scholar
20.Daley, CL, Small, PM, Schecter, GF, Schoolnik, GK, McAdam, RA, Jacobs, WR, et al.An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus: an analysis using restriction fragment length polymorphisms. N Engl J MedGoogle Scholar