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Free Content Investigation of cross contamination in a Mycobacterium tuberculosis laboratory using IS6110 DNA fingerprinting

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Setting: A laboratory for routine culturing of Mycobacterium tuberculosis.

Objective: Investigation of an episode of laboratory cross contamination using IS6110 restriction fragment length polymorphism (RFLP) typing. Improvement of laboratory protocols to prevent contaminations in the future. To stress the importance of ‘good laboratory practice’, and interaction with clinicians about laboratory results.

Design: Fingerprinting of mycobacterial isolates from 1) cultures suspected of being contaminated and 2) strains suspected of being the source of the cross-contamination.

Results: RFLP typing results indicated that clinical samples were contaminated by strains which had been processed in species identification procedures one day earlier in the same safety cabinet. This cross contamination also resulted in exceptional RFLP typing results—mixed banding patterns. Three patients were treated on the basis of false-positive laboratory results. Because the laboratory results were confusing for the clinicians, the treatment of one true tuberculosis patient was severely delayed.

Conclusion: ‘Good laboratory practice’ is very important to prevent cross contamination. RFLP typing proved to be a useful tool to trace the source of contamination. Interaction with clinicians receiving doubtful results is of the utmost importance.
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Keywords: DNA fingerprinting; Mycobacterium tuberculosis; RFLP typing; laboratory cross contamination

Document Type: Regular Paper

Affiliations: 1: Regional Medical Microbiological Laboratory, Zuiderziekenhuis, Rotterdam, The Netherlands 2: Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

Publication date: 01 May 1998

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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