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  1. Effectiveness of a nosocomial tuberculosis control program at an urban teaching hospital.

    Article - En anglais

    Study objective 

    To assess the effectiveness of a nosocomial tuberculosis (TB) program at an urban teaching hospital.

    Design 

    Retrospective review.

    Setting 

    An urban teaching hospital, the University of California, San Diego Medical Center (UCSD), which cares for 25 to 30 culture-proven pulmonary TB cases (>80% of which are smear-positive) per year.

    Study population 

    Health-care workers.

    Measurements 

    (1) Purified protein derivative (PPD) conversion rates. (2) Cases of active TB among health-care workers. (3) Compliance rates with isoniazid (INH) preventive therapy.

    Results 

    The UCSD program was evaluated for the years 1993 to 1995.

    The PPD conversion rate among established employees was 0.6%. Of 556 employees who had an exposure, 494 (88.8%) were compliant with follow-up.

    Three hundred thirty-seven were skin-tested (the other 157 already had a known PPD>10 mm).

    Only 2 of 337 (0.6%) converted.

    One case of active TB, unrelated to any documented hospital exposure, was discovered in 3 years among approximately 5,000 employees per year (follow-up for convertors, 18 to 54 months).

    Only 48.4% of eligible employees completed at least 6 months of INH preventive therapy.

    Conclusions 

    UCSD's TB control measures appear to be effective in the prevention of nosocomial transmission of TB.

    Despite poor compliance with INH preventive therapy, cases of active TB among health-care workers were rare.

    Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Hôpital, Personnel sanitaire, Programme, Dépistage, Prévalence, Isoniazide, Observance médicamenteuse, Exploration, Homme, Maladie professionnelle, Epidémiologie, Antituberculeux, Antibiotique, Chimiothérapie, Prévention, Traitement, Infection nosocomiale

    Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Hospital, Health staff, Program, Medical screening, Prevalence, Isoniazid, Drug compliance, Exploration, Human, Occupational disease, Epidemiology, Antituberculous agent, Antibiotic, Chemotherapy, Prevention, Treatment

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0292273

    Code Inist : 002B05B02O. Création : 27/11/1998.