Viability of mycobacteria in formalin-fixed lungs

It is generally accepted that the risk of contracting tuberculosis is relatively high among medical laboratory workers and pathologists. Nevertheless, there is an assumption that once tissue is fixed in formalin, the risk for transmission and subsequent infection of mycobacteria is greatly reduced, if not altogether eliminated. To test the viability of potentially infectious mycobacteria in formalin-fixed tissue, tissue specimens from autopsy lungs fixed in formalin were cultured for mycobacteria. Of 138 cases with histologic evidence of acid-fast bacilli, 12 grew mycobacteria, including 3 Mycobacterium tuberculosis isolates, suggesting that there is a risk of contracting tuberculosis from tissue that has been fixed in formalin, if aerosolization or accidental inoculation should occur.