[MCOH-EH] Infection Control and Lab Safety for handling surgical specimens that may contain M. tuberculosis or other mycobacteria

[Michael Sauri, MD, MPH&TM, FACP, FACPM]

Dr. Galaid,

I would recommend the following USPHS guidance for answers to your infection
control questions concerning the handling of suspected
tuberculosis-containing specimens in the laboratory.

 

Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in
Health-Care Settings, 2005; Prepared by Paul A. Jensen, PhD, Lauren A.
Lambert, MPH, Michael F. Iademarco, MD, Renee Ridzon, MD

Division of Tuberculosis Elimination, National Center for HIV, STD, and TB
Prevention;  MMWR, Recommendations and Reports; December 30, 2005 / 54
(RR17); pp 1-141.

 

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5417a1.htm

 

Sincerely,

Michael 

 

Michael A. Sauri, MD, MPH&TM, FACP

FACPM, FACOEM, FRSTM&H, CTropMed

Medical Director

Occupational Health Consultants

2301 Research Blvd., Suite 125

Rockville, MD 20850

www.ohcmd.com <http://www.ohcmd.com/> 

Tel 301-738-6420

Fax 301-990-3534

 <mailto:msauri at ohcmd.com> msauri at ohcmd.com

 

From: MCOH-EH <mcoh-eh-bounces+msauri=ohcmd.com at mylist.net> On Behalf Of
Galaid, Edward via MCOH-EH
Sent: Wednesday, September 18, 2024 9:23 PM
To: mcoh-eh at mylist.net; occ-env-med-l digest recipients
<occ-env-med-l at listserv.unc.edu>
Cc: Galaid, Edward <Edward.Galaid at rsfh.com>
Subject: [MCOH-EH] Infection Control and Lab Safety for handling surgical
specimens that may contain M. tuberculosis or other mycobacteria

 

Our histopath techs have expressed concern over how, in retrospect, they
should have handled surgical specimens that were subsequently found to
contain M. tuberculosis.   I don't know if the specimens were placed
directly into fixative at the time they were obtained, but I'll find out.
I'm going to assume that formalin would inactivate live bacteria.  The techs
are asking about periodic IGRAs.

 

If the specimen were transported to the lab in some other medium or saline
or just in an empty container, what is the risk of generating a biohazardous
aerosol while the specimen was being prepared for embedding and eventually
sliced on a microtome?  I assume that the specimens are not routinely
macerated or ground up or centrifuged.   I am also going to find out if they
have a protocol is for handling specimens in hoods.  Are there other
questions that should be addressed.

 

Thanks for the time to respond.  

 

Ed

 

Edward I. Galaid, MD, MPH, FACOEM

ABIM, ABPM (OM)

Medical Director, Occupational Medicine

Roper Saint Francis Healthcare

Charleston, SC 29401

Chair, Public Safety Medicine Section, American College of Occupational and
Environmental Medicine

Special Expert, NFPA Fire Service Occupational Safety & Health (FIX-AAA)
Committee

843-402-5053

 

 

 

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