Control of nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis among healthcare workers and HIV-infected patients.
From 1988 to 1990, an outbreak of multidrug-resistant tuberculosis (MDR-TB) among patients, and an increased number of tuberculin-skin-test conversions among healthcare workers, occurred on the HIV ward of Jackson Memorial Hospital, Miami, Florida, USA.
Measures similar to those subsequently recommended in the 1990 Centers for Disease Control and Prevention guidelines were implemented on the HIV ward by June, 1990, and in September, 1992, we evaluated the efficacy of these control measures.
Among MDR-TB patients and healthcare workers with tuberculin-skin-test conversions on the HIV ward, we looked for evidence of exposure to HIV ward MDR-TB patients positive for acid-fast bacilli in sputum during initial (January-May, 1990) and follow-up (June, 1990-June, 1992) periods.
Exposure before implementation of control measures to an infectious MDR-TB patient on the HIV ward was recorded in 12 of 15 (80%) MDR-TB patients during the initial period and 5 of 11 (45%) MDR-TB patients during follow-up.
After implementation of control measures, no episodes of MDR-TB could be traced to contact with infectious MDR-TB patients on the HIV ward.
Skin-test conversions among workers on the HIV ward declined from 7 of 25 (28%) during the initial period to 3 of 17 (18%) in the early (June, 1990-February, 1991) and 0 of 23 in the late (March, 1991-June, 1992) follow-up periods (p<0.18).
Mots-clés Pascal : Appareil respiratoire pathologie, Immunopathologie, SIDA, Virose, Infection, Bactériose, Médecine travail, Exposition professionnelle, Epidémiologie, Facteur risque, Homme, Etude statistique, Résistance traitement, Tuberculose, Mycobactériose, Transmission homme homme, Personnel sanitaire, Immunodéficit, Infection nosocomiale
Mots-clés Pascal anglais : Respiratory disease, Immunopathology, AIDS, Viral disease, Infection, Bacteriosis, Occupational medicine, Occupational exposure, Epidemiology, Risk factor, Human, Statistical study, Negative therapeutic reaction, Tuberculosis, Mycobacterial infection, Transmission from man to man, Health staff, Immune deficiency, Nosocomial infection
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0226334
Code Inist : 002B05B02O. Création : 09/06/1995.