Hostname: page-component-77c89778f8-swr86 Total loading time: 0 Render date: 2024-07-17T13:04:53.829Z Has data issue: false hasContentIssue false
  • English
  • Français

Tuberculosis in Hemodialysis Patients in New Jersey: A Statewide Study

Published online by Cambridge University Press:  02 January 2015

Teresa A. Simon ,
Sindy Paul ,
Daniel Wartenberg  and
Jerome I. Tokars
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
Get access Rights & Permissions [Opens in a new window]

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
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 9 , September 1999 , pp. 607 - 609
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

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. Hussein, MM, Bakir, N, Roujouleh, H. Tuberculosis in patients undergoing maintenance dialysis. Nephrol Dial Transplant 1990;5:584–587.CrossRefGoogle ScholarPubMed
2. Heaton, ND, Severn, A, Rennie, JA, Atypical presentation of tuberculosis following long-term hemodialysis. Br J Urol 1989;64:433–434.Google Scholar
3. Neves, PL, Xavier, P, Pinto, I, Anunciada, AI, Santos, V, Andrade, L, et al. Unusual presentation of renal tuberculosis: end-stage renal disease. Nephrol Dial Transplant 1993;8:288–289.Google ScholarPubMed
4. Rutsky, EA, Rostand, SG. Mycobacteriosis in patients with chronic renal failure. Arch Intern Med 1980;140:57–61.Google Scholar
5. Garcia-Leoni, ME, Martin-Scapa, C, Rodeno, P, Valderrabano, F, Moreno, S, Bouza, E. High incidence of tuberculosis in renal patients. Eur J Clin Microbiol Infect Dis 1990;9:283–285.CrossRefGoogle ScholarPubMed
6. Mitwalli, A Tuberculosis in patients on maintenance dialysis. Am J Kidney Dis 1991;18:579–582.Google Scholar
7. Andrew, OT, Schoenfeld, PY, Hopewell, PC, Humphreys, MH. Tuberculosis in patients with end-stage renal disease. Am J Med 1980;68:59–65.Google Scholar
8. Hachicha, J, Jarraya, A High incidence of tuberculosis in chronic dialysis patients in developing countries. Nephron 1989;52:189.CrossRefGoogle ScholarPubMed
9. Chia, S, Karim, M, Edward, RK, Fitzgerald, JM. Risk of tuberculosis (TB) in dialysis (D) patients: a population based study. American Lung Association/American Thoracic Society, May 10-15,1996. Poster J25.Google Scholar
10. Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 1995. Atlanta, GA US Department of Health and Human Services; 1996:11.Google Scholar
11. Lundin, AP, Adler, AJ, Berlyne, GM, Friedman, EA, Tuberculosis in patients undergoing maintenance hemodialysis. Am J Med 1979;67:597–602.CrossRefGoogle ScholarPubMed
12. Mattern, WD, Hak, LJ, LaManna, RW, Teasley, KM, Loffell, MS. Malnutrition, altered immune function and the risk of infection in maintenance hemodialysis patients. Am J Kidney Dis 1982;1:206–215.CrossRefGoogle ScholarPubMed
13. Tokars, JI, Miller, E, Alter, MJ, Arduino, MJ. National surveillance of dialysis-associated diseases in the United States, 1995. Atlanta, GA US Department of Health and Human Services; 1997.Google Scholar
14. US Renal Data System. USRDS 1996 annual data reports. Bethesda, MD: National Institutes of Health, National Institutes of Diabetes and Kidney Diseases; 1996:1–164.Google Scholar
15. Wayne, D. Biostatistics: A Foundation for Analysis in the Health Sciences. 5th ed. John Wiley & Sons; 1991:73–81.Google Scholar
16. Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities, 1994. MMWR 1994;43(RR-13):1–132.Google Scholar
17. Centers for Disease Control and Prevention. Guidelines for preventing the transmission of tuberculosis in healthcare settings, with special focus on HIV-related issues. MMWR 1990;39(RR-17):1–29.Google Scholar
18. New Jersey Department of Health. Guidelines for the prevention of tuberculosis transmission in healthcare facilities. Trenton NJ: New Jersey Department of Health, Division of Epidemiology, Environmental and Occupational Health Services; 1994.Google Scholar
19. Tokars, JI, Miller, B. Tuberculin skin testing of ESRD patients. Am J Kidney Dis 1997;30:456–457.CrossRefGoogle ScholarPubMed
20. Hegeman, TF, York, S, Bennington, M. Surveillance after tuberculosis exposure and anergy testing in ESRD Patients. J Am Soc Nephrol 1993;4:352. Abstract.Google Scholar