       Document 1000
 DOCN  M9651000
 TI    Tuberculosis among urban health care workers: a study using restriction
       fragment length polymorphism typing.
 DT    9505
 AU    Sepkowitz KA; Friedman CR; Hafner A; Kwok D; Manoach S; Floris M;
       Martinez D; Sathianathan K; Brown E; Berger JJ; et al; Division of
       Infectious Diseases, Cornell University Medical; College, New York, New
       York, USA.
 SO    Clin Infect Dis. 1995 Nov;21(5):1098-101. Unique Identifier : AIDSLINE
       MED/96125988
 AB    Cases of tuberculosis identified during 1992-1994 through an active
       tuberculosis surveillance network among six hospitals that serve New
       York City (the TBNetwork) were analyzed according to the occupational
       status of the patients. Clinical data were obtained by review of medical
       records, and restriction fragment length polymorphism (RFLP) typing of
       Mycobacterium tuberculosis isolates was performed. No known nosocomial
       outbreaks of tuberculosis occurred at these hospitals in the study
       period. Occupational status was known for 142 of 201 patients whose
       isolates were available for strain typing. Patients infected by
       organisms with a clustered strain typing pattern, as determined by RFLP
       analysis, were presumed to have recently acquired disease. RFLP typing
       revealed that isolates from 13 (65%) of 20 health care workers and 50
       (41%) of 122 non-health care workers had a clustered RFLP pattern. The
       strains infecting eight (89%) of nine health care workers seropositive
       for human immunodeficiency virus (HIV) had a clustered RFLP pattern.
       Multivariate analysis of 75 patients with known HIV and occupational
       status revealed that HIV status (P = .03) and health care worker status
       (P = .02; RR = 2.77) were independent risk factors for a clustered RFLP
       strain. These findings suggest that many of the apparently sporadic
       cases of tuberculosis among health care workers may be due to
       unrecognized occupational transmission.
 DE    Adult  Bacterial Typing Techniques  Cluster Analysis  Epidemiology,
       Molecular  Female  *Health Personnel  Human  Male  Middle Age
       Mycobacterium tuberculosis/CLASSIFICATION/GENETICS/ISOLATION &  PURIF
       New York City/EPIDEMIOLOGY  Occupational
       Diseases/*EPIDEMIOLOGY/MICROBIOLOGY  Polymorphism, Restriction Fragment
       Length  Risk Factors  Support, Non-U.S. Gov't  Tuberculosis,
       Pulmonary/*EPIDEMIOLOGY/MICROBIOLOGY/TRANSMISSION  Urban Population
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

