Prevention of nosocomial spread of multidrug-resistant tubercle bacilli.

Outbreaks of multidrug-resistant Mycobacterium tuberculosis (multidrug-resistant tuberculosis; MDR-TB) have recently been reported in hospitals in the United States. Rapid spread of these bacilli and a high mortality among immunocompromised patients, i.e. HIV-infected individuals and AIDS patients, were observed. Factors that play a role in these outbreaks and the prevention of MDR-TB are discussed in this article. Awareness of a possible M. tuberculosis infection and the early introduction of measures to reduce the spread of these micro-organisms are steps that can prevent a nosocomial outbreak. The use of more rapid methods for culturing mycobacteria and determining their sensitivity to antimicrobial drugs can accelerate the diagnostic process and the recognition of multiresistance. In view of the poor results of treatment of MDR-TB, prevention should be the first requirement.