Annals of internal medicine · 1997
A nosocomial outbreak of multidrug-resistant tuberculosis.
СтатьяПоддержка исследования: вне правительства СШАПоддержка службы здравоохранения СШАНазвание и аннотация: Перевод в очереди
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Kenyon T A, Ridzon R, Luskin-Hawk R, Schultz C, Paul W S, Valway S E, Onorato I M, Castro K
Аннотация
BACKGROUND: An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms.
OBJECTIVE: To identify risk factors for transmission of Mycobacterium tuberculosis.
DESIGN: Retrospective cohort study.
SETTING: Private hospital.
PARTICIPANTS: Patients and health care workers exposed to M. tuberculosis.
MEASUREMENTS: Analysis of M. tuberculosis isolates, tuberculin skin testing, assessment of exposure, and assessment of participant characteristics.
RESULTS: All seven M. tuberculosis isolates had matching DNA fingerprints. Of patients exposed to M. tuberculosis, those who developed tuberculosis had lower CD4+ T-lymphocyte counts (P = 0.02) and were more likely to be ambulatory (P = 0.03) than those who did not. Of 74 exposed health care workers, the 11 (15%) who had conversion on tuberculin skin testing were no more likely than those who did not have conversion to report that they always wore a respirator with a high-efficiency particulate air filter.
CONCLUSIONS: Transmission of M. tuberculosis occurred in a hospital that did not have recommended isolation rooms. A respirator-fit testing program did not protect health care workers in this setting.
OBJECTIVE: To identify risk factors for transmission of Mycobacterium tuberculosis.
DESIGN: Retrospective cohort study.
SETTING: Private hospital.
PARTICIPANTS: Patients and health care workers exposed to M. tuberculosis.
MEASUREMENTS: Analysis of M. tuberculosis isolates, tuberculin skin testing, assessment of exposure, and assessment of participant characteristics.
RESULTS: All seven M. tuberculosis isolates had matching DNA fingerprints. Of patients exposed to M. tuberculosis, those who developed tuberculosis had lower CD4+ T-lymphocyte counts (P = 0.02) and were more likely to be ambulatory (P = 0.03) than those who did not. Of 74 exposed health care workers, the 11 (15%) who had conversion on tuberculin skin testing were no more likely than those who did not have conversion to report that they always wore a respirator with a high-efficiency particulate air filter.
CONCLUSIONS: Transmission of M. tuberculosis occurred in a hospital that did not have recommended isolation rooms. A respirator-fit testing program did not protect health care workers in this setting.