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由于实验室交叉污染导致的Mycobacterium结核病伪爆发:分子流行病学爆发调查
Nayla Léveillé1, Floriane Point2, Josée Houde3
1Faculté de Médecine, Département de Médicine, Université de Montréal, Montréal, QC.
一个实验室交叉污染事件导致了蒙特利尔的结核病 (TB) 伪爆发. 包括全基因组测序在内的分子类型测定在四名患者中证实了相同的分离物,导致停止结核病治疗.
科学领域:
- 临床微生物学 临床微生物学
- 传染性疾病 传染性疾病
- 基因组学就是基因组学.
背景情况:
- 在加拿大,常规菌根菌培养诊断结核病 (TB).
- 全球估计表明,高达2%的阳性结核病培养可能是错误的阳性由于实验室交叉污染.
- 一个可疑的结核病伪爆发涉及五名来自不同机构的患者,在中央实验室处理.
研究的目的:
- 为了调查由实验室交叉污染引起的疑似结核病伪爆发.
- 在疫情调查中评估常规型化 (MIRU-VNTR) 和全基因组测序 (WGS) 的实用性.
主要方法:
- 审查了患者的流行病学风险因素和临床表现.
- 追溯样本轨迹以确定交叉污染点.
- 使用MIRU-VNTR和牛津纳米孔技术 (ONT) 进行全基因组测序的特征化Mycobacterium结核病分离物.
主要成果:
- 四名患者的培养基接种时间重叠,包括器官捐赠者和接受者.
- 在这四名患者中,通过MIRU-VNTR和WGS确认了相同的Mycobacterium结核病分离物.
- 两名患者呈现出典型的结核病症状和暴露史.
结论:
- 临床,实验室和分子数据证实实验室交叉污染是结核病伪爆发的原因.
- 全基因组测序为调查提供了强有力的证据.
- 结核病治疗在受影响的患者中断,包括器官移植接受者.
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