Rodrigues C, Almeida D, Shenai S, Goyal N, Mehta A
Hinduja Hospital and MRC, Veer Savarkar Marg, Mahim West, Mumbai, Maharashtra, India.
Indian J Med Microbiol. 2007 Jan;25(1):4-6. doi: 10.4103/0255-0857.31053.
Unrecognized cross-contamination has been known to occur in laboratories frequently, especially with sensitive recovery system like BACTEC 460 TB. In March 2001, we investigated a pseudo-outbreak of Mycobacterium tuberculosis isolates in three smear negative clinical specimens and would like to present our experience in this communication.
All suspected cases were confirmed by checking the drug susceptibility and DNA fingerprints using spoligotyping as well as restriction fragment length polymorphism.
On investigation, the most likely cause was found to be the use of common decontamination reagents and phosphate buffer.
To avoid erroneous diagnosis, we have devised a dedicated decontamination procedure, which includes separate aliquoting of phosphate buffer and decontamination reagents per patient. Timely molecular analysis and appropriate changes to specimen processing have been identified as useful measures for limiting laboratory cross contamination.
实验室中经常会出现未被识别的交叉污染情况,尤其是在使用像BACTEC 460 TB这样的敏感回收系统时。2001年3月,我们调查了三例涂片阴性临床标本中结核分枝杆菌分离株的假性暴发情况,并希望在本通讯中分享我们的经验。
所有疑似病例均通过检测药物敏感性以及使用间隔寡核苷酸分型(spoligotyping)和限制性片段长度多态性分析DNA指纹图谱来确诊。
经调查,最可能的原因是使用了共用的去污试剂和磷酸盐缓冲液。
为避免错误诊断,我们设计了一种专门的去污程序,其中包括为每位患者分别分装磷酸盐缓冲液和去污试剂。及时进行分子分析以及对标本处理进行适当调整已被确定为限制实验室交叉污染的有效措施。