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Varied Approaches to Tuberculosis Control in a Multihospital System

Published online by Cambridge University Press:  02 January 2015

Keith F. Woeltje ,
Paul B. L'Ecuyer ,
Sondra Seiler  and
Victoria J. Fraser
Keith F. Woeltje
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri
Paul B. L'Ecuyer
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri Division of General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri
Sondra Seiler
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri
Victoria J. Fraser*
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St Louis, Missouri
*
Division of Infectious Diseases, Washington University School of Medicine, 660 S Euclid, Campus Box 8051, St Louis, MO 63110
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Abstract

Objectives:

To document the actual tuberculosis (TB) control policies and procedures in a nonoutbreak setting in a variety of hospitals. To determine if any particular practices are linked to higher rates of employee tuberculin skin-test conversion.

Design:

Survey of hospital occupational health and infection control practitioners for the year 1994 regarding hospital TB policies. Review of hospital records to verify the number of patients with TB at each hospital and to verify the number of employees with positive tuberculin skin tests. Smoke-stick testing of negative-pressure ventilation rooms.

Setting:

A 13-hospital health system in the Midwest.

Results:

Hospitals ranged in size from 40 to 1,208 beds (median 220) and employed 150 to 6,500 workers (median 875). There were seven rural and six urban centers, including four teaching hospitals. All 13 hospitals had TB control plans, and all performed annual tuberculin skin testing on employees. Annual skin-test positivity rates ranged from 0% to 1.0% (median 0.3%). Negative-pressure ventilation rooms were available in 11 hospitals. The percentage of negative-pressure rooms with effective negative pressure ranged from 44% to 100% (median 95%). Three of the 13 hospitals used high-efficiency particulate air (HEPA) masks as primary personal respiratory protection, and 8 used dust-mist or dust-mist-fume masks. We found no relation between the type of face mask used, number of functional negative-pressure rooms, or hospital TB risk category, and employee skin-test conversion rates.

Conclusions:

Considerable variation existed in the TB control policies and procedures between hospitals, but employee TB skin-test conversion rates were low in all settings.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 8 , August 1997 , pp. 548 - 553
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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