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Tuberculosis in Hemodialysis Patients in New Jersey: A Statewide Study

Published online by Cambridge University Press:  02 January 2015

Teresa A. Simon*
Affiliation:
New Jersey University of Medicine and Dentistry, Trenton, New Jersey
Sindy Paul
Affiliation:
New Jersey State Department of Health and Human Services, Atlanta, Georgia
Daniel Wartenberg
Affiliation:
New Jersey University of Medicine and Dentistry, Trenton, New Jersey
Jerome I. Tokars
Affiliation:
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, Georgia
*
7 Haines Cove Dr, Toms River, NJ 08753

Abstract

Objective:

To study the incidence of tuberculosis (TB), tuberculin skin testing (TST) practices, and infection control practices at outpatient hemodialysis centers.

Design:

Mail surveys performed in December 1994 and 1995.

Main Outcome Measures:

The numbers of patients with incident active TB during 1994 and 1995, TST policies during 1994, and TB infection control policies in 1994.

Setting:

All outpatient dialysis centers in New Jersey.

Patients or Participants:

Healthcare workers and patients in dialysis centers in New Jersey.

Results:

Of 47 centers, 41 provided information on TST and TB infection control policies and practices. TSTs were performed on newly hired healthcare workers at all 41 centers and on established workers at 39 centers. In contrast, only 1 center reported performing TSTs on hemodialysis patients; 5 other centers reported screening of patients for TB using chest radiographs. Active TB was reported in 3 of 4,550 chronic hemodialysis patients in 1994 (rate, 66/100,000 patient-years) and in 4 of 4,831 patients in 1995 (rate, 83/100,000 patient-years). Both rates were several times higher than the rate in the New Jersey general population during this period (10.7-10.8/100,000).

Conclusion:

Although based on small numbers of patients with TB, we found a relatively high incidence of TB among hemodialysis patients in New Jersey. Most centers reported performing TSTs on workers but not on patients. These results suggest the need for improved TB screening and infection control precautions at outpatient dialysis centers.

Type
Orginal Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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