Using DNA fingerprinting to detect transmission of Mycobacterium tuberculosis among AIDS patients in two health-care facilities in Puerto Rico.
BACKGROUND
Fourteen cases of tuberculosis (TB) in Puerto Rico, diagnosed from April 1993 to April 1995, had the same DNA fingerprint, documenting disease caused by the same strain of Mycobacterium tuberculosis. The 14 cases were retrospectively investigated for epidemiologic links.


METHODS
Records were reviewed and staffs of the TB program, hospital/clinic, and AIDS residential facilities were interviewed.


RESULTS
Half of the AIDS cases were epidemiologically related, providing evidence of TB transmission in an emergency department, an AIDS inpatient ward, and an AIDS residential facility. DNA fingerprinting allowed detection of M tuberculosis transmission, but contact investigators could have documented it sooner. Factors contributing to transmission included delayed diagnosis, prolonged infectiousness, inadequate discharge planning and infection control procedures, and poor communication between health-care facilities.


CONCLUSIONS
The numbers of AIDS residential facilities are increasing and must understand proper monitoring of TB patients and infection control measures that prevent transmissions.
Hennessey
K A
KA
Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Schulte
J M
JM
Valway
S E
SE
Joglar
O T
OT
Rios
N
N
Sheppard
J D
JD
Onorato
I M
IM
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission*; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission*; D016172:DNA Fingerprinting / Q000379:methods*; D004269:DNA, Bacterial / Q000032:analysis* / Q000235:genetics; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D017053:Infection Control; D008297:Male; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D011647:Puerto Rico / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D011795:Surveys and Questionnaires; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission*
D004269:DNA, Bacterial