NOSOCOMIAL TRANSMISSION OF TUBERCULOSIS INFECTION IN PEDIATRICS WARDS

Analysis of restriction fragment length polymorphisms is a well establ ished method of ''DNA fingerprinting'' that has been used to trace the transmission of particular strains of Mycobacterium tuberculosis duri ng investigations of outbreaks. This report describe the use of restri ction fragment length polymorphisms and arbitrarily primed polymerase chain reaction analysis to investigate two outbreaks of tuberculosis t hat affected six children who attended two pediatric wards in our hosp ital. In both outbreaks a history of household exposure to an adult wi th M. tuberculosis was obtained and suspected tuberculous contacts wer e identified. We have demonstrated unequivocally the strain relationsh ip among the isolates in all the cases by restriction fragment length polymorphisms and arbitrarily primed polymerase chain reaction analysi s. These techniques are very useful for performing epidemiologic studi es of tuberculosis in children where natural history of tuberculosis i nfection is different from that in adults in that it is almost always primary infection rather than reactivation.