OBJECTIVES: To determine the reason for an increase in tuberculin skin test (TST) conversion in employees in a nursing home and to determine the source case responsible for spread of tuberculosis (TB) in two nursing homes and a hospital in a rural part of Arkansas using molecular and traditional epidemiological methods. DESIGN: TB contact investigation of residents and employees of two nursing homes and a hospital. SETTING: Two nursing homes and a hospital in rural part of Arkansas. PARTICIPANTS: One hundred fifty-seven employees and 117 residents of two nursing homes and 211 employees of a hospital in rural part of Arkansas. MEASUREMENTS: Tuberculin skin test. RESULTS: Analysis of room and work assignments of residents and employees who converted their TSTs in Nursing Home A showed that residents and employees in the same wing as the suspect source case were significantly more likely to have converted their TST than residents and employees in other wings (P = .01). A nurse from the local hospital where the suspected source case had been sent developed a tuberculous cervical abscess, and one employee in Nursing Home A developed pulmonary TB. A visitor to Nursing Home A was diagnosed with culture-positive pulmonary TB 2 years later. Genotyping of the Mycobacterium tuberculosis isolates from the four secondary cases showed identical patterns. CONCLUSION: Molecular and traditional epidemiological studies revealed an outbreak of TB that began in a nursing home and spread to a second nursing home, a local hospital, and the community.
OBJECTIVES: To determine the reason for an increase in tuberculin skin test (TST) conversion in employees in a nursing home and to determine the source case responsible for spread of tuberculosis (TB) in two nursing homes and a hospital in a rural part of Arkansas using molecular and traditional epidemiological methods. DESIGN: TB contact investigation of residents and employees of two nursing homes and a hospital. SETTING: Two nursing homes and a hospital in rural part of Arkansas. PARTICIPANTS: One hundred fifty-seven employees and 117 residents of two nursing homes and 211 employees of a hospital in rural part of Arkansas. MEASUREMENTS: Tuberculin skin test. RESULTS: Analysis of room and work assignments of residents and employees who converted their TSTs in Nursing Home A showed that residents and employees in the same wing as the suspect source case were significantly more likely to have converted their TST than residents and employees in other wings (P = .01). A nurse from the local hospital where the suspected source case had been sent developed a tuberculous cervical abscess, and one employee in Nursing Home A developed pulmonary TB. A visitor to Nursing Home A was diagnosed with culture-positive pulmonary TB 2 years later. Genotyping of the Mycobacterium tuberculosis isolates from the four secondary cases showed identical patterns. CONCLUSION: Molecular and traditional epidemiological studies revealed an outbreak of TB that began in a nursing home and spread to a second nursing home, a local hospital, and the community.
Authors: Giorgio Guzzetta; Marco Ajelli; Zhenhua Yang; Leonard N Mukasa; Naveen Patil; Joseph H Bates; Denise E Kirschner; Stefano Merler Journal: J Theor Biol Date: 2015-06-05 Impact factor: 2.691
Authors: David A Jackson; Karen Mailer; Kimberly A Porter; R Todd Niemeier; Donna A Fearey; Linda Pope; Lauren A Lambert; Kiren Mitruka; Marie A de Perio Journal: Am J Infect Control Date: 2015-05-05 Impact factor: 2.918
Authors: Philip W Smith; Gail Bennett; Suzanne Bradley; Paul Drinka; Ebbing Lautenbach; James Marx; Lona Mody; Lindsay Nicolle; Kurt Stevenson Journal: Infect Control Hosp Epidemiol Date: 2008-09 Impact factor: 3.254
Authors: Philip W Smith; Gail Bennett; Suzanne Bradley; Paul Drinka; Ebbing Lautenbach; James Marx; Lona Mody; Lindsay Nicolle; Kurt Stevenson Journal: Am J Infect Control Date: 2008-09 Impact factor: 2.918
Authors: Sina Helbig; Sergey Rekhtman; Kristen Dostie; Alexander Casler; Thomas Schneider; Natasha S Hochberg; Lisa Ganley-Leal Journal: Glob Vaccines Immunol Date: 2016-05-27