Viability of mycobacteria in formalin-fixed lungs

Gerston, K F; Blumberg, Lucille; Tshabalala, Vusi A; Murray, Jill

doi:10.1016/j.humpath.2004.01.009

Cited by 32 publications

(20 citation statements)

References 14 publications

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“…tuberculosis can survive for years after the death of an infected individual and after preservation in formalin [38,39]. In our cohort, seven (64%) of the 11 individuals with M .…”

Section: Discussionmentioning

confidence: 99%

Autopsy Prevalence of Tuberculosis and Other Potentially Treatable Infections among Adults with Advanced HIV Enrolled in Out-Patient Care in South Africa

et al. 2016

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BackgroundEarly mortality among HIV-positive adults starting antiretroviral therapy (ART) remains high in resource-limited settings, with tuberculosis (TB) the leading cause of death. However, current methods to estimate TB-related deaths are inadequate and most autopsy studies do not adequately represent those attending primary health clinics (PHCs). This study aimed to determine the autopsy prevalence of TB and other infections in adults enrolled at South African PHCs in the context of a pragmatic trial of empiric TB treatment (“TB Fast Track”).Methods and FindingsAdults with CD4 ≤150 cells/μL, not on ART or TB treatment, were enrolled to TB Fast Track and followed up for at least six months. Minimally invasive autopsy (MIA) was conducted as soon as possible after death. Lungs, liver, and spleen were biopsied; blood, CSF, and urine aspirated; and bronchoalveolar lavage fluid obtained. Samples underwent mycobacterial, bacterial, and fungal culture; molecular testing (including Xpert® MTB/RIF); and histological examination. 34 MIAs were conducted: 18 (53%) decedents were female; median age was 39 (interquartile range 33–44) years; 25 (74%) deaths occurred in hospitals; median time from death to MIA was five (IQR 3–6) days. 16/34 (47%) had evidence of TB (14/16 [88%] with extrapulmonary disease; 6/16 [38%] not started on treatment antemortem); 23 (68%) had clinically important bacterial infections; four (12%) cryptococcal disease; three (9%) non-tuberculous mycobacterial disease; and two (6%) Pneumocystis pneumonia. Twenty decedents (59%) had evidence of two or more concurrent infections; 9/16 (56%) individuals with TB had evidence of bacterial disease and two (13%) cryptococcal disease.ConclusionsTB, followed by bacterial infections, were the leading findings at autopsy among adults with advanced HIV enrolled from primary care clinics. To reduce mortality, strategies are needed to identify and direct those at highest risk into a structured pathway that includes expedited investigation and/or treatment of TB and other infections.

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“…tuberculosis can survive for years after the death of an infected individual and after preservation in formalin [38,39]. In our cohort, seven (64%) of the 11 individuals with M .…”

Section: Discussionmentioning

confidence: 99%

Autopsy Prevalence of Tuberculosis and Other Potentially Treatable Infections among Adults with Advanced HIV Enrolled in Out-Patient Care in South Africa

et al. 2016

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“…fungal spores) aerosols (e.g. tuberculosis [9,10,18,24]) and viruses (e.g. HIV, HCV, H5N1 flu) replaced the conventional surgical mask as standard protection.…”

Section: Change Of Occupational Safety Measuresmentioning

confidence: 99%

Cut-resistant protective gloves in pathology—effective and cost-effective

et al. 2008

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Cutting injuries and needle-stitch injuries constitute a potentially fatal danger to both pathologists and autopsy personnel. We evaluated such injuries in a large German institute of pathology from 2002 to 2007 and analysed the effect of the introduction of cut-resistant gloves on the incidence of these injuries. In the observation period, 64 injuries (48 cutting injuries and 16 needle-stitch injuries) were noted in the injury report books. Most injuries were located at the non-dominant hand, preferentially at the index finger and the thumb. Around one fifths of the injuries were at the side of handedness. The average number of injuries per month was 1.22 for the 50 months prior to the introduction of cut-resistant gloves, more than seven times higher than after their introduction (0.158; 19 months; p < 0.001). Considering the medical and administrational costs of such injuries, cut-resistant protective gloves are an effective and cost-effective completion of personal occupational safety measures in surgical pathology and autopsy. We strongly recommend the use of such gloves, especially for autopsy personnel.

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“…The DNA detected by PCR may represent intact, but dead mycobacteria, of which the phospholipids' particles of the bacterial wall are capable of irritating the humoral immune system. It has been shown that mycobacteria may survive in human bodies after death (Nolte, 2005), and survive in tissues after long-term preservation (Thoen and Bloonm, 1995;Grange, 1996;Gerston et al, 1998Gerston et al, , 2004Barnes et al, 2000;Park et al, 2003). It is also possible that this DNA may represent viable mycobacteria of this kind, residing in calcified tissue of parenchymatous organs, or in the bone marrow of recovered individuals.…”

Section: Discussionmentioning

confidence: 99%

Risk assessment of mycobacterial infections (human tuberculosis and avian mycobacteriosis) during anatomical dissection of cadavers

Bartoš¹,

Pavlíková²,

Dvorská³

et al. 2006

Vet. Med. - Czech

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The aim of this work was to study the presence of mycobacteria in tissue samples from four cadavers fixed with formalin, and tissue samples from a recently deceased unpreserved individual, who had a history of human tuberculosis infection, undergoing a post mortem (cause of death not related to tuberculosis). All were examined for the presence of tuberculous lesions and the specific presence of Mycobacterium tuberculosis complex (MTC) and M. avium complex (MAC) members by microscopy, culture, and PCR analysis of four genomic elements (IS6110, mtp40, IS901, and IS1245). Microscopy examination after the Ziehl-Neelsen staining and culture examination for the presence of mycobacteria were negative in all 22 tissue samples from the four embalmed cadavers. PCR analysis of IS6110 and mtp40 was positive in tissue samples of tuberculous lesions from the lungs of two embalmed cadavers, and from intact kidney tissue of one of these cadavers. Microscopy and culture examinations of liver and spleen tissues from the unpreserved cadaver were positive for mycobacteria. PCR analysis, specific for M. avium subsp. avium, was positive in both tissue samples with, and without tuberculous lesions.

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Viability of mycobacteria in formalin-fixed lungs

Cited by 32 publications

References 14 publications

Autopsy Prevalence of Tuberculosis and Other Potentially Treatable Infections among Adults with Advanced HIV Enrolled in Out-Patient Care in South Africa

Autopsy Prevalence of Tuberculosis and Other Potentially Treatable Infections among Adults with Advanced HIV Enrolled in Out-Patient Care in South Africa

Cut-resistant protective gloves in pathology—effective and cost-effective

Risk assessment of mycobacterial infections (human tuberculosis and avian mycobacteriosis) during anatomical dissection of cadavers

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