Contamination and transmission of Mycobacteria in indoor environments of public buildings.

OBJECTIVES: The aim of this study was to detect Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare, Mycobacterium contamination and to explore the aerosol transmission of mycobacteria in public buildings in China. METHODS: A total of 552 environmental samples, namely 165 aerosol, 199 water, 70 air duct dust, and 118 soil samples, were collected from 39 public buildings and analysed using nested polymerase chain reaction. RESULTS: The positivity rate of Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare in air samples were 0.6% and 1.8%, respectively. There was significant difference in the positivity rate of Mycobacterium aerosol among the three types of public building (χ2 = 6.108, p = 0.047). No positive results of Mycobacterium tuberculosis complex and M. avium and M. intracellulare were obtained from cooling, tap, shower, or fountain water. The positivity rate of Mycobacterium for water samples was 31.7% (63/199). The positivity rate of Mycobacterium tuberculosis complex, M. avium subsp. avium and M. intracellulare, Mycobacterium in soil samples were 1.1%, 34.6% and 43.6%, respectively. There was significant difference in the positivity rate of M. avium and M. intracellulare (χ2 = 47.219, p < 0.001) and Mycobacterium (χ2 = 33.535, p < 0.001) in the different origins of soil samples. CONCLUSIONS: Mycobacteria are widespread in public buildings. Mycobacterium tuberculosis complex, M. avium and M. intracellulare were simultaneously present in the air ducts of central air conditioning systems and indoor air in public buildings, which indicates that aerosol transmission is a potential route.

Supramalleolar Osteotomy With or Without Fibular Osteotomy for Varus Ankle Arthritis.

BACKGROUND: Supramalleolar osteotomy (SMOT) is an alternative operative procedure for the management of early and midstage varus ankle arthritis. However, whether fibular osteotomy is needed is controversial. The purpose of the current study was to evaluate the functional and radiologic outcomes of pre- and postoperative SMOT, and to compare the outcomes between patients with and without fibular osteotomy. METHODS: Forty-one Takakura stage 2 and 3 varus ankle osteoarthritis patients treated with SMOT were included. Fourteen males and 27 females with a mean age of 50.7 (range, 32-71) years were followed with a mean of 36.6 (range, 17-61) months. There were 22 cases with fibular osteotomy and 19 without. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Maryland foot score, and Ankle Osteoarthritis Score (AOS) were used for pre- and postoperative functional evaluation. The tibial articular surface angle (TAS), talar tilt (TT), tibiocrural angle (TC), and tibial lateral surface angle (TLS) were evaluated pre- and postoperatively. RESULTS: At the last follow-up, the mean AOFAS score (from 50.8 to 83.1 points) and Maryland score (from 58.3 to 81.6 points) in overall were improved (P < .01); the mean AOS pain (from 42.6 to 26.1 points) and function (from 53.4 to 36.8 points) scores were decreased (P < .01). For radiologic evaluation, all the included parameters were improved (P < .05) except TLS. The mean Takakura stage was decreased (P < .01). No significant difference could be detected in comparing the functional outcomes between those with and without fibular osteotomy. However, in the fibular osteotomy group, TT was decreased (P < .05) and TC was improved (P < .01) significantly. CONCLUSION: SMOT was promising, with substantial functional improvement and malalignment correction for varus ankle arthritis. Fibular osteotomy may be necessary in cases with large TT and small TC angles. LEVEL OF EVIDENCE: Level III, retrospective comparative study.