Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T20:34:19.895Z Has data issue: false hasContentIssue false
  • English
  • Français

Correlation Between Frequency of Tuberculosis and Compliance With Control Strategies

Published online by Cambridge University Press:  02 January 2015

Marie-Claude Roy ,
Mary Fredrickson ,
Natalie L. Good ,
S. Ann Hunter  and
Mary D. Nettleman
Marie-Claude Roy*
Affiliation:
Division of General Medicine, Clinical Epidemiology and Health Services Research, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Mary Fredrickson
Affiliation:
Iowa City Veterans' Administration Medical Center, Iowa City, Iowa
Natalie L. Good
Affiliation:
Iowa City Veterans' Administration Medical Center, Iowa City, Iowa
S. Ann Hunter
Affiliation:
Iowa City Veterans' Administration Medical Center, Iowa City, Iowa
Mary D. Nettleman
Affiliation:
Medical College of Virginia, Richmond, Virginia
*
Hôpital L'Enfant-Jésus, Microbiologie, 1401-18 Rue, Québec G1J 1Z4, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine if compliance with annual tuberculosis skin testing correlated with the number of cases of tuberculosis seen in patients and healthcare workers.

Design:

Survey using a written questionnaire.

Setting and Participants:

159 Veterans' Administration facilities.

Results:

Hospitals that reported that >80% of their healthcare workers received annual skin tests saw 12.7 patient cases per 10,000 admissions and 4.0 healthcare worker cases per 10,000 personnel. Facilities in which <20% of their healthcare workers were given annual skin tests saw 4.5 cases per 10,000 admissions and 1.6 cases in healthcare workers per 10,000 personnel (P<.001 for patients and P=.31 for healthcare workers). The ratio of the median number of patients placed in acid-fast bacilli (AFB) isolation to the median number of patients with confirmed tuberculosis was 12. There was no correlation of this ratio with the number of cases of tuberculosis in patients or healthcare workers seen in each facility.

Conclusion:

Compliance with annual tuberculosis skin testing was related directly to the rate of tuberculosis seen in patients. More standardized policies for placing patients in AFB isolation are needed to control for potentially costly variation among facilities. These measures should have highest priority in the control of tuberculosis in the healthcare setting, before implementing still more expensive interventions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 1 , January 1997 , pp. 28 - 31
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Myers, JA. The prevention of tuberculosis among nurses. Am J Nurs 1930;30:1361–1372.Google Scholar
2. Sepkowitz, KA. Tuberculosis and the health care worker: a historical perspective. Ann Intern Med 1994:120:71–79.Google Scholar
3. Vogeler, DM, Burke, JP. Tuberculosis screening for hospital health care workers. A five-year experience in a large community hospital. American Review of Respiratory Diseases 1978; 117:227–232.Google Scholar
4. McGowan, JE Jr. The booster effect—a problem for the surveillance of tuberculosis in hospital health care workers. Infect Control 1980;1:147–149.CrossRefGoogle Scholar
5. Jereb, JA, Kelly, GD, Dooley, SW, Cauthen, GW, Snider, DE. Tuberculosis morbidity in the United States. MMWR 1991;40(SS-3):23.Google Scholar
6. 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.Google Scholar
7. Dooley, SW, Villarino, ME, Lawrence, M, et al. Nosocomial transmission of tuberculosis in a hospital unit for HIV-infected patients. JAMA 1992;267:2632–2635.Google Scholar
8. Edlin, BR, Tokars, JI, Grieco, MH, et al. An outbreak of multidrugresistant tuberculosis among hospitalized patients with the acquired immunodeficiency syndrome. N Engl J Med 1992;326:1514–1521.CrossRefGoogle ScholarPubMed
9. Beck-Sagué, 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.CrossRefGoogle ScholarPubMed
10. Ramirez, JA, Anderson, P, Herp, S, Raff, MJ. Increased rate of tuberculin skin test conversion among workers at a university hospital. Infect Control Hosp Epidemiol 1992;13:579–581.Google Scholar
11. Nettleman, MD, Fredrickson, M, Good, NL, Hunter, SA. Tuberculosis control strategies: the cost of particulate respirators. Ann Intern Med 1994;121:37–40.Google Scholar
12. Craven, RB, Wenzel, RP, Atuk, NO. Minimizing tuberculosis risk to hospital personnel and students exposed to unsuspected disease. Ann Intern Med 1975;82:628–632.CrossRefGoogle ScholarPubMed
13. Fraser, VJ, Kilo, CM, Bailey, TC, Medoff, G, Dunagan, WC. Screening of physicians for tuberculosis. Infect Control Hosp Epidemiol 1994;15:95–100.Google Scholar
14. Raad, I, Cusick, J, Sherertz, RJ, Sabbagh, M, Howell, N. Annual tuberculin skin testing of employees at a university hospital: a costbenefit analysis. Infect Control Hosp Epidemiol 1989;10:465–469.Google Scholar
15. Lowenthal, G, Keys, T. Tuberculosis surveillance in hospital employees: are we doing too much? Infect Control 1986;7:209–211.CrossRefGoogle ScholarPubMed