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Reduction in Tuberculin Skin-Test Conversions Among Medical House Staff Associated with Improved Tuberculosis Infection Control Practices

Published online by Cambridge University Press:  02 January 2015

David R. Bangsberg*
Affiliation:
Columbia-Presbyterian Medical Center, New York City, New York
Kathleen Crowley
Affiliation:
Columbia-Presbyterian Medical Center, New York City, New York
Andrew Moss
Affiliation:
Department of Epidemiology and Biostatistics, San Francisco General Hospital, University of California-San Francisco
Jay F. Dobkin
Affiliation:
Columbia-Presbyterian Medical Center, New York City, New York
Carlton McGregor
Affiliation:
Columbia-Presbyterian Medical Center, New York City, New York
Harold C. Neu
Affiliation:
Columbia-Presbyterian Medical Center, New York City, New York
*
Center for AIDS Prevention Studies, A Component of the AIDS Research Institute, University of California–San Francisco, Box 0886, 74 New Montgomery St, Suite 600, San Francisco, CA 94105-0886

Abstract

Objective:

To assess the efficacy of an infection control program as measured by tuberculin skin-test (TST) conversion rates in medical house staff.

Design:

Observational study.

Setting:

University-based hospital in New York City serving a large indigent population.

Participants:

Medical house staff.

Interventions:

TST conversions were measured every 6 months in medical house staff from June 1992 to June 1994. Compliance with the isolation policy was measured by identifying room locations 24 hours after admission of patients who had Mycobacterium tuberculosis recovered from respiratory specimens.

Results:

The TST conversion rate decreased from 5.8 to 0, 2.3, and 0 per 100 person years of exposure in successive 6-month periods. The estimated annual TST conversion rate among interns fell from 7 per 100 person years in June 1992 to 0 per 100 person years in June 1993 and 0 per 100 person years in June 1994 (P=.029). The proportion of patients with pulmonary tuberculosis who were isolated in negative-pressure rooms increased from 38% to 75% over the study period (P=.01).

Conclusion:

Development of a multifaceted infection control program can decrease the risk of nosocomial tuberculosis infection in medical house staff.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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