Braden C R, Templeton G L, Stead W W, Bates J H, Cave M D, Valway S E
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 1997 Jan;24(1):35-40. doi: 10.1093/clinids/24.1.35.
In 1992-1993, we investigated possible cross-contamination of Mycobacterium tuberculosis cultures as part of a study of tuberculosis in Arkansas by using DNA fingerprint analysis. Of patients whose isolates were matched, those for whom smears were negative and only one culture was positive were identified from laboratory records. Clinical, laboratory, DNA fingerprint, and epidemiological data were reviewed. Of 259 patients, nine (3.5%) were judged to be due to cross-contamination. None of these patients had a clinical course consistent with tuberculosis. All nine specimens were processed with another isolate with a matching DNA fingerprint, and epidemiological connections were not identified among any of the patients. To avoid erroneous diagnoses and unnecessary therapy and public health investigations, specimens from patients with tuberculosis whose smears are negative and only one culture is positive should be investigated for cross-contamination. An inconsistent clinical course and a DNA fingerprint that matches those of other culture-positive specimens processed concurrently, coupled with the lack of an epidemiological connection, suggest cross-contamination.
1992年至1993年期间，作为阿肯色州结核病研究的一部分，我们利用DNA指纹分析调查了结核分枝杆菌培养物可能存在的交叉污染情况。从实验室记录中找出分离株匹配的患者，其中涂片阴性且仅一份培养物呈阳性的患者。对临床、实验室、DNA指纹和流行病学数据进行了审查。在259名患者中，有9名（3.5%）被判定为交叉污染所致。这些患者均无符合结核病的临床病程。所有9份标本均与另一份具有匹配DNA指纹的分离株一起处理，且未在任何患者之间发现流行病学关联。为避免错误诊断、不必要的治疗和公共卫生调查，对于涂片阴性且仅一份培养物呈阳性的结核病患者的标本，应调查是否存在交叉污染。临床病程不一致、DNA指纹与同时处理的其他培养阳性标本匹配，且缺乏流行病学关联，提示存在交叉污染。
