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Tuberculosis in Healthcare Workers Caring for a Congenitally Infected Infant

Published online by Cambridge University Press:  02 January 2015

Françoise Mouchet ,
Valérie Hansen ,
Inge Van Herreweghe ,
Olivier Vandenberg ,
Régine Van Hesse ,
Michèle Gérard ,
Michèle Toppet ,
Maryse Wanlin ,
Véronique Toppet  and
Georges Casimir
...Show all authors
Françoise Mouchet*
Affiliation:
Department of Pediatrics, St. Pierre University Hospital, Brussels, Belgium
Valérie Hansen
Affiliation:
Neonatal Intensive Care Unit, St. Pierre University Hospital, Brussels, Belgium
Inge Van Herreweghe
Affiliation:
Neonatal Intensive Care Unit, St. Pierre University Hospital, Brussels, Belgium
Olivier Vandenberg
Affiliation:
Department of Microbiology and Molecular Diagnosis Center, St. Pierre University Hospital, Brussels, Belgium
Régine Van Hesse
Affiliation:
Department of Infectious Disease, St. Pierre University Hospital, Brussels, Belgium
Michèle Gérard
Affiliation:
Department of Infectious Disease, St. Pierre University Hospital, Brussels, Belgium
Michèle Toppet
Affiliation:
Hopital Universitaire des Enfants, HUDERF, Brussels, Belgium
Maryse Wanlin
Affiliation:
Fondation centre les Affections Respiratoires et pour l'Education à la Santé, FARES (a.s.b.l), Brussels, Belgium
Véronique Toppet
Affiliation:
Department of Pediatric Radiology, St. Pierre University Hospital, Brussels, Belgium
Georges Casimir
Affiliation:
Hopital Universitaire des Enfants, HUDERF, Brussels, Belgium
Dominique Haumont
Affiliation:
Neonatal Intensive Care Unit, St. Pierre University Hospital, Brussels, Belgium
Jack Levy
Affiliation:
Department of Pediatrics, St. Pierre University Hospital, Brussels, Belgium
*
C.H.U. SAINT - PIERRE, rue haute 322, B-1000 Brussels, Belgium
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Abstract

Objective:

To assess the extent of nosocomial transmission of tuberculosis among infants, family members, and healthcare workers (HCWs) who were exposed to a 29-week-old premature infant with congenital tuberculosis, diagnosed at 102 days of age.

Design:

A prospective exposure investigation using tuberculin skin test (TST) conversion was conducted. Contacts underwent two skin tests 10 to 12 weeks apart. Clinical examination and chest radiographs were performed to rule out disease. Isoniazid prophylaxis was administered to exposed infants at higher risk.

Setting:

A neonatal intensive care unit in an urban hospital in Brussels, Belgium.

Participants:

Ninety-seven infants, 139 HCWs, and 180 visitors.

Results:

Newly positive TST results occurred in HCWs who had been in close contact with the infant. Six (19%) of 32 primary care nurses and physicians had TST conversions and received treatment. Among the 97 exposed infants, 85 were screened and 34 were identified as at higher risk of infection. Of these, 27 received preventive isoniazid. None of the infants and none of the 93 other infants' family members evaluated were infected.

Conclusions:

Congenital tuberculosis in an infant poses a risk for nosocomial transmission to HCWs. Delayed diagnosis of this rare disease and close proximity are the most important factors related to transmission.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 12 , December 2004 , pp. 1062 - 1066
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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