HCW infected with HIV and MDR-TB
A health care worker infected with occupationally acquired HIV subsequently was exposed to tuberculosis in a hospital and developed multi-drug-resistant TB, according to a recently published study in Infection Control and Hospital Epidemiology.1
In March 1990, a 32-year-old phlebotomist had a skin test conversion after being exposed to two TB patients. Two months later, the healthcare worker sustained a deep needlestick injury while drawing blood from an AIDS patient. The worker did not receive post-exposure prophylaxis for HIV but did receive isoniazid preventive therapy, which was never completed. The worker seroconverted for HIV several months later but did not develop TB until five years later, at which point it was found to be resistant to rifampin and isoniazid.
After conducting DNA fingerprinting of the workers strain and matching it to AIDS patients exposed to an outbreak of MDR-TB at the hospital, it was determined that the worker acquired the TB infection while on the job.
The findings underscore the importance of following recommendations that immunosuppressed health care workers exposed to TB should receive preventive TB therapy regardless of their skin-test status, the authors report.
Reference
1. Ridzon R, Kenyon T, Luskin-Hawk R, et al. Nosocomial transmission of HIV and subsequent transmission of MDR-TB in a healthcare worker. Infect Control Hosp Epidemiol 1997; 18:422-424.
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