title: Congenital tuberculosis and management of exposure in neonatal and pediatric intensive care units.
abstract: METHODS
  This report describes the management and outcome of neonatal intensive care unit (NICU) and paediatric ICU (PICU) exposure to a 26-day-old premature infant with congenital tuberculosis (TB).
  
  
  METHODS
  The infant's mother underwent chest X-ray (CXR) and sputum culture. Contacts of the infant were identified. Tuberculin skin tests (TSTs) were performed on 97 infants and children, 156 NICU and PICU visitors and 115 health care workers.
  
  
  RESULTS
  The mother's sputum culture was positive for Mycobacterium tuberculosis. No TST conversion occurred in the exposed NICU infants. All neonates received prophylactic isoniazid (INH). One exposed child in the PICU had TST conversion with normal CXR and completed 9 months of INH without developing active disease; 22 (14%) PICU and NICU visitors and 3 NICU personnel had TST conversion without evidence of disease.
  
  
  CONCLUSIONS
  The sequence of events described here demonstrates the difficulty in diagnosis and management of TB in this age group. Transmission of TB in NICU and PICUs is unusual but can occur, and calls for a systematic approach to investigation of the exposed infants, family members and health care providers.
authors.affiliation: Pediatric Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Grisaru-Soen
authors.affiliation: Tel Aviv Health District, Ministry of Health, Tel Aviv, Israel.
authors.forename: M
authors.initials: M
authors.lastname: Savyon
authors.affiliation: Department of Pediatric Intensive Care, Dana-Dwek Children's Hospital, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Sadot
authors.affiliation: Division of Epidemiology and Preventive Medicine, Israel.
authors.forename: V
authors.initials: V
authors.lastname: Schechner
authors.affiliation: Department of Pediatric Intensive Care, Dana-Dwek Children's Hospital, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Sivan
authors.affiliation: Microbiology Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Faculty of Nursing, Yezreel Valley College, Yezreel Valley, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Schwartz
authors.affiliation: Division of Epidemiology and Preventive Medicine, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Tarabeia
authors.affiliation: Tel Aviv Health District, Ministry of Health, Tel Aviv, Israel.
authors.forename: Z
authors.initials: Z
authors.lastname: Amitai
authors.affiliation: Tel Aviv Health District, Ministry of Health, Tel Aviv, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Yoabov
authors.affiliation: Department of Pediatric Intensive Care, Dana-Dwek Children's Hospital, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Carmeli
mesh_terms: D000391:Air Microbiology; D000995:Antitubercular Agents / Q000627:therapeutic use; D016358:Contact Tracing; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional; D007363:Intensive Care Units, Neonatal; D015278:Intensive Care Units, Pediatric; D007538:Isoniazid / Q000627:therapeutic use; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D016273:Occupational Exposure; D010356:Patient Isolation; D011237:Predictive Value of Tests; D011247:Pregnancy; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D016896:Treatment Outcome; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000635:transmission*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid