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
Tel 301-738-6420
Fax 301-990-3534
From: MCOH-EH <mcoh-eh-bounces+msauri=ohcmd.com@mylist.net> On Behalf Of Galaid, Edward via MCOH-EH
Sent: Wednesday, September 18, 2024 9:23 PM
To: mcoh-eh@mylist.net; occ-env-med-l digest recipients <occ-env-med-l@listserv.unc.edu>
Cc: Galaid, Edward <Edward.Galaid@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
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