Second Nationwide Tuberculosis Outbreak Caused by Bone Allografts Containing Live Cells - United States, 2023.

Autor: Wortham JM, Haddad MB, Stewart RJ, Annambhotla P, Basavaraju SV, Nabity SA, Griffin IS, McDonald E, Beshearse EM, Grossman MK, Schildknecht KR, Calvet HM, Keh CE, Percak JM, Coloma M, Shaw T, Davidson PJ, Smith SR, Dickson RP, Kaul DR, Gonzalez AR, Rai S, Rodriguez G, Morris S, Armitige LY, Stapleton J, Lacassagne M, Young LR, Ariail K, Behm H, Jordan HT, Spencer M, Nilsen DM, Denison BM, Burgos M, Leonard JM, Cortes E, Thacker TC, Lehman KA, Langer AJ, Cowan LS, Starks AM, LoBue PA
Jazyk: angličtina
Zdroj: MMWR. Morbidity and mortality weekly report [MMWR Morb Mortal Wkly Rep] 2024 Jan 05; Vol. 72 (5253), pp. 1385-1389. Date of Electronic Publication: 2024 Jan 05.
DOI: 10.15585/mmwr.mm725253a1
Abstrakt: During July 7-11, 2023, CDC received reports of two patients in different states with a tuberculosis (TB) diagnosis following spinal surgical procedures that used bone allografts containing live cells from the same deceased donor. An outbreak associated with a similar product manufactured by the same tissue establishment (i.e., manufacturer) occurred in 2021. Because of concern that these cases represented a second outbreak, CDC and the Food and Drug Administration worked with the tissue establishment to determine that this product was obtained from a donor different from the one implicated in the 2021 outbreak and learned that the bone allograft product was distributed to 13 health care facilities in seven states. Notifications to all seven states occurred on July 12. As of December 20, 2023, five of 36 surgical bone allograft recipients received laboratory-confirmed TB disease diagnoses; two patients died of TB. Whole-genome sequencing demonstrated close genetic relatedness between positive Mycobacterium tuberculosis cultures from surgical recipients and unused product. Although the bone product had tested negative by nucleic acid amplification testing before distribution, M. tuberculosis culture of unused product was not performed until after the outbreak was recognized. The public health response prevented up to 53 additional surgical procedures using allografts from that donor; additional measures to protect patients from tissue-transmitted M. tuberculosis are urgently needed.
Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Saroj Rai reports uncompensated service as the Association of Immunization Managers’ (AIM) liaison to CDC’s Advisory Committee on Immunization Practices – Chikungunya Workgroup and on the Legacy Council for AIM; and retirement stocks at Novartis Pharmaceuticals. Jeffrey M. Percak reports travel support from the County of San Diego and from the California Tuberculosis Controller’s Association for attendance at the California Tuberculosis Controller’s Association fall meeting. Lisa Y. Armitige reports support from the Texas Department of State Health Services, consulting fees (paid to institution) from the Kansas Health Department, and honoraria (forwarded to institution) from the American Academy of HIV Medicine. No other potential conflicts of interest were disclosed.
Databáze: MEDLINE
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