In Practice

Tuberculosis transmission in a hospitalised neonate: Need for optimised tuberculosis screening of pregnant and postpartum women

J Zenhäusern, A Bekker, M A Wates, H S Schaaf, A Dramowski

Abstract


A recent fatal case of confirmed nosocomial tuberculosis (TB) transmission to a neonate in a kangaroo mother care (KMC) unit highlighted the infection risk to hospitalised neonates in South Africa, a high-burden TB setting. The index case was a 9-week-old infant who presented to another hospital’s intensive care unit with severe respiratory distress shortly after discharge from the KMC unit. Contact tracing identified that the infant had been exposed to a postpartum woman with undiagnosed pulmonary TB while in the KMC unit. Molecular testing confirmed nosocomial transmission between the index case and the presumed source case in the KMC unit. We describe the subsequent process of tracing other TB-exposed infants and mothers, the difficulty in confirming TB infection/disease in pregnancy, and the provision of isoniazid preventive therapy in this cohort. We discuss the practical implementation of TB screening approaches in maternity and neonatal wards in high-burden TB settings.


Authors' affiliations

J Zenhäusern, Department of Paediatrics, Karl Bremer Hospital, Cape Town, South Africa

A Bekker, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, and Tygerberg Hospital, Cape Town, South Africa

M A Wates, Department of Paediatrics, Karl Bremer Hospital, Cape Town, South Africa

H S Schaaf, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, and Tygerberg Hospital, Cape Town, South Africa

A Dramowski, Academic Unit for Infection Prevention and Control, Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Full Text

PDF (413KB)

Keywords

Mycobacterium tuberculosis; Kangaroo mother care; TB screening; Isoniazid preventive therapy; Neonate; Nosocomial TB transmission

Cite this article

South African Medical Journal 2019;109(5):310-313. DOI:10.7196/SAMJ.2019.v109i5.13789

Article History

Date submitted: 2019-04-29
Date published: 2019-04-29

Article Views

Abstract views: 234
Full text views: 170

Comments on this article

*Read our policy for posting comments here