Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Tuberculosis screening is not mandatory for prospective tissue donors. In 2021 and 2023, two different bone allograft products caused nationwide tuberculosis outbreaks. We assessed the morbidity and mortality of the second outbreak and reviewed donor and tissue screening to identify deficiencies. Thirty-six people residing in nine states received the product during spinal and dental procedures. Twenty-seven recipients had tuberculosis infection, 11 had microbiologic or imaging evidence of tuberculosis disease, and two died from tuberculosis within 12 months of outbreak detection. Another recipient died from tuberculosis nearly 3 years after product implantation. The bone donor died of pneumonia and septic shock. Polymerase chain reaction testing of the product before and after distribution did not detect Mycobacterium tuberculosis . Mycobacterial culture was not performed until after outbreak detection, when M. tuberculosis was isolated from 2 of 6 unused product units. This outbreak demonstrates persistent gaps in tissue transplant safety. Appropriate selection of donors and mycobacterial culture of donated tissues could reduce but not eliminate the risk of M. tuberculosis transmission. Therefore, it is important that clinicians monitor tissue recipients and promptly report adverse events to tissue establishments and health authorities.
Source: medRxiv
Authors: Kimberly R. Schildknecht, Paula M. Williams, Noah G. Schwartz, Maryam B. Haddad, Rebekah J. Stewart, Pallavi Annambhotla, Sridhar V. Basavaraju, Scott A. Nabity, Chris E. Keh, Helene M. Calvet, Matthew M. Zahn, Romina Beltrán, Ashley Cortez, Andrea Lomeli, Jeffrey M. Percak, Lisa L. Goozé, Myron Coloma, Tambi Shaw, Peter J. Davidson, Shona R. Smith, Robert P. Dickson, Daniel R. Kaul, Annett R. Gonzalez, Gretchen Rodriguez, Amanda Decimo, Audilis Sanchez, Lisa Y. Armitige, Jessica Stapleton, Michael Lacassagne, Chris Brown, Crystal Zheng, Juzar Ali, Amy W. Wolfe, Laura R. Young, Kiley Ariail, Heidi Behm, Hannah T. Jordan, Magdalene Spencer, Diana M. Nilsen, RuthAnn Goradia, Brenda Montoya Denison, Marcos Burgos, Juliet M. Leonard, Erick Cortes, Tyler C. Thacker, Kimberly A. Lehman, Julian A. Villalba, Julu Bhatnagar, Sarah Reagan-Steiner, Sandy P. Althomsons, Neela D. Goswami, Lauren S. Cowan, Angela M. Starks, Jonathan M. Wortham, Philip A. LoBue, the Bone Allograft Tuberculosis 2023 Investigators
Institutions: Centers for Disease Control and Prevention, National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention, Epidemic Intelligence Service, National Center for Emerging and Zoonotic Infectious Diseases, California Department of Public Health, Orange County Healthcare Agency, Health and Human Services Agency, San Mateo County Health System, Michigan Department of Health and Human Services, University of Michigan, Texas Department of State Health Services, The University of Texas at Tyler, The University of Texas Health Science Center at Tyler, Louisiana State Department of Health and Hospitals, Tulane University, Louisiana State University Health Sciences Center New Orleans, Virginia Department of Health, New York City Department of Health and Mental Hygiene, New Mexico Department of Health, New Jersey Department of Health, United States Department of Agriculture
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7160401153