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SHEA-CDC TB Survey, Part I: Status of TB Infection Control Programs at Member Hospitals, 1989-1992

Published online by Cambridge University Press:  02 January 2015

Scott K. Fridkin ,
Lilia Manangan ,
Elizabeth Bolyard ,
William R. Jarvis  and
The Society for Healthcare Epidemiology of America
Scott K. Fridkin*
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Lilia Manangan
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Elizabeth Bolyard
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia Society for Healthcare Epidemiology of America, West Deptford, New Jersey
William R. Jarvis
Affiliation:
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia Society for Healthcare Epidemiology of America, West Deptford, New Jersey
*
Hospital Infections Program, Mailstop E-69, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333
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Abstract

Objective:

To determine trends in Mycobacterium tuberculosis infection in healthcare workers, tuberculosis (TB) control measures, and compliance with the 1990 Centers for Disease Control and Prevention (CDC) guideline for preventing transmission of TB in healthcare facilities.

Design:

Voluntary questionnaire sent to all members of the Society for Healthcare Epidemiology of America, representing 359 hospitals.

Results:

Respondents’ hospitals (210 [58%]) had a median of 2,400 healthcare workers (range, 396 to 13,745), 437 beds (range, 48 to 1,250), 5.6 patients with TB per year (range, 0 to 492), and 0 multidrug-resistant (MDR) TB patients per year (range, 0 to 33). Of 166 respondents’ hospitals for which data were provided for 1989 through 1992, the number caring for MDR-TB patients increased from 10 (6%) in 1989 to 49 (30%) in 1992. Reported policies for routine healthcare worker tuberculin skin testing varied. The median skin-test positivity rate for healthcare workers at the time of hire increased from 0.54% in 1989 to 0.81% in 1992, but the median conversion rate during routine testing remained similar: 0.35% in 1989 and 0.33% in 1992. Among 196 hospitals with reported data on respiratory protection use for 1989 through 1992, the use of either surgical submicron, dust-mist, or dust-fume-mist respirators for healthcare workers increased from 9 (5%) in 1989 to 85 (43%) in 1992. Of 181 hospitals with reported data, 113 (62%) had acid-fast bacilli isolation facilities consistent with the 1990 CDC guideline (ie, a single patient room, negative air pressure relative to the hallway, air exhausted directly outside, and ≥ 6 air exchanges per hour).

Conclusions:

While the number of surveyed hospitals caring for TB and MDR-TB patients increased during 1989 through 1992, TB infection control measures at many hospitals still did not meet the 1990 CDC guideline recommendations.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 3 , March 1995 , pp. 129 - 134
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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References

1. Centers for Disease Control. Tuberculosis morbidity-United States, 1992. Emerging infectious diseases. MMWR 1993;42:696–704.Google Scholar
2. Beck-Sague, C, Dooley, SW, Hutton, MD, et al. Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections; factors in transmission to staff and HIV-infected patients. JAMA 1992;268:1280–1286.Google Scholar
3. Pearson, ML, Jereb, JA, Frieden, TR, et al. Nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis; a risk to patients and health care workers. Ann Intern Med 1992;117:191–196.CrossRefGoogle ScholarPubMed
4. Edlin, BR, Tokars, JI, Grieco, MH, et al. An outbreak of multidrug-resistant tuberculosis among hospitalized patients with acquired immunodeficiency syndrome. N Engl J Med 1992;326:1514–1521.10.1056/NEJM199206043262302Google Scholar
5. Jarvis, WR. Nosocomial transmission of multidrug-resistant Myco-bacterium tuberculosis . Res Microbiol 1993;144:117–122.Google Scholar
6. Centers for Disease Control. Nosocomial transmission of multidrug-resistant tuberculosis among HIV-infected persons-Florida and New York, 1988-1991. MMWR 1991;40:585–591.Google Scholar
7. Coronado, VG, Beck-Sague, CM, Hutton, MD, et al. Transmission of multidrug-resistant Mycobacterium tuberculosis among persons with human immunodeficiency virus infection in an urban hospital: epidemiologic and restriction fragment length polymorphism analysis. J Infect Dis 1993;168:1052–1055.CrossRefGoogle Scholar
8. Centers for Disease Control. Guidelines for preventing the transmission of tuberculosis in health-care settings, with special focus on HIV-related issues. MMWR 1990;39(RRl7):1–29.Google Scholar
9. Wenger, PN, Otten, J, Breeden, A, Orfas, D, Beck-Sague, CM, Jarvis, WR. Control of nosocomial transmission of multidrugresistent Mycobacterium tuberculosis among health care workers and HIV-infected patients. Lancet 1995;345:235–240.CrossRefGoogle Scholar
10. Stroud, L. Tokars, J. Grieco, M. Gilligan, M. larvis, W. Interruntion of nosocomial transmission of multidrug-resistant Mycobackium tuberculosis among AIDS patients in a New York City hospital. Presented at the Third Annual Meeting of the Society for Healthcare Epidemiology of America; April 18-20,1993; Chicago, Illinois. Al.Google Scholar
11. Maloney, SA, Pearson, ML, Gordon, MT, Castillo, RD, Boyle, JF, Jarvis, WR. Efficacy of control measures in preventing nosocomial transmission of multidrug-resistant tuberculosis to patients and health care workers. Ann intern Med 1995;122:90–95.Google Scholar
12. PC SAS, Release 6.03, Software for Data Analysis. Cary NC: Sas Institute Inc; 1988.Google Scholar
13. Schlesselman, JJ. Case-Control Studies. New York, NY: Oxford University Press; 1982::203–206.Google Scholar
14. Rudnick, J, Kroc, K, Manangan, L, Banejee, S, Pugliese, G, Jarvis, W. How prepared are U.S. hospitals to control nosocomial transmission of tuberculosis? Presented at the First World Congress on Tuberculosis; November 1518, 1992; Rockville, Maryland.Google Scholar
15. National Institute of Occupational Safety and Health. Recommended Guidelines for Personal Respiratory Protection of Workers in Health-Care Facilities Potentially Exposed to Tuberculosis. Atlanta, GA: Centers for Disease Control and Prevention; 1992.Google Scholar
16. U.S. Labor Department's Occupational Safety and Health Administration. Memorandum for Regional Administrators, Enforcement Policy and Procedures for Occupational Exposure to Tuberculosis. Washington, DC; U.S. Department of Labor; October 20,1993.Google Scholar