第二次全国性结核病爆发是由含有活细胞的骨移植引起的 - 美国,2023年
MMWR. Morbidity and mortality weekly report
|January 4, 2024
概括
两名患者在使用骨移植进行脊椎手术后患有结核病 (TB). 这凸显了迫切需要更好的查,以防止组织传播的Mycobacterium结核病感染.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 外科手术的安全性
背景情况:
- 结核病 (TB) 的传播可以通过受污染的外科移植发生.
- 2021年之前的一次疫情涉及类似的组织产品.
研究的目的:
- 为了调查可能发生的第二次结核病爆发,结核病与骨移植有关.
- 为了确定传输的来源和范围.
- 推改进的安全措施.
主要方法:
- 病例调查和接触者追踪由CDC和FDA进行.
- 全基因组测序Mycobacterium结核病分离物. 结核病分离物的全基因组测序.
- 对组织采购和检测程序的审查.
主要成果:
- 在36名来自单一捐赠者的骨移植接受者中,有5人患有结核病;2人死亡.
- 全基因组测序证实了患者和产品分离物之间的遗传相关性.
- 涉及的骨移植产品在分发前通过核酸测试对结核病呈阴性,但在疫情爆发后为培养阳性.
结论:
- 受污染的骨移植在手术过程中构成结核病传播的重大风险.
- 目前的核酸测试可能无法检测到低水平的Mycobacterium结核病在所有移植.
- 增强的Mycobacterium结核病查,包括培养,对于组织安全至关重要.
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