Shishido S, Mori T, Kawai M
Division of Respiratory Disease, National Matsue Hospital, Japan.
Kekkaku. 1994 Sep;69(9):543-7.
The high incidence of tuberculosis among necropsy workers is well known and several problems related to their working conditions have been pointed out. We investigated the possibility of infection with tubercle bacilli under necropsy working conditions using guinea pigs housed in a necropsy room in which about 2,000 necropsies per year were carried out. Tuberculosis infection developed in one out of five guinea pigs. In addition, we exposed five guinea pigs to tubercle bacilli and sacrificed them in a safety cabinet. The lungs, livers, and spleens were resected, flattened, and sliced finely on a cutting board. Detection of tubercle bacilli from filtered air and the surfaces of the room was attempted, however, no bacilli were cultured. The resected tuberculous lungs were intra-tracheally treated with formalin or physiological saline and the viability of the bacilli in the lung was assessed. Bacilli survived up to two hours after physiological saline injection but no viable organisms were detected after 15 minutes of formalin treatment. These findings indicate that the necropsy room workers were exposed to tuberculosis infection. As a preventive control measure, we recommend to treat tuberculous organs in the safety cabinet and to slice lungs after formalin treatment.
尸检工作人员中结核病的高发病率是众所周知的,并且已经指出了一些与其工作条件相关的问题。我们利用安置在每年进行约2000例尸检的尸检室中的豚鼠,调查了在尸检工作条件下感染结核杆菌的可能性。五只豚鼠中有一只发生了结核感染。此外,我们让五只豚鼠接触结核杆菌并在安全柜中将它们处死。切除肺、肝和脾,在案板上展平并切成薄片。尝试从过滤空气中和房间表面检测结核杆菌,但未培养出杆菌。对切除的结核性肺组织进行气管内福尔马林或生理盐水处理,并评估肺内杆菌的活力。生理盐水注射后杆菌存活长达两小时,但福尔马林处理15分钟后未检测到活菌。这些发现表明尸检室工作人员面临结核感染风险。作为预防控制措施,我们建议在安全柜中处理结核性器官,并在福尔马林处理后切片肺组织。