Real and apparent tuberculin skin test conversions in a group of medical students.
OBJECTIVE
To evaluate tuberculin skin test (TST) conversions among a group of medical students.


METHODS
Questionnaire sent to a medical school class in whom a cluster of TST conversions was noted, and interview and repeat TST of students with conversion.


METHODS
County hospital and associated medical school.


METHODS
Medical students, after their third year in medical school.


RESULTS
Of 165 students in the class, 115 (70%) responded; 10 reported TST conversions between the beginning of the third and the fourth year. Seven of 10 were interviewed, and all 10 were retested. Five students, all in a cohort who tested each other during a clinical clerkship with a tuberculin material previously reported to be associated with a high rate of false-positive TSTs, were TST negative on repeat. Five had persistently positive TSTs. One was exposed during a psychiatry clerkship to a resident with pulmonary tuberculosis. Four students appeared to have converted their TST during their third year in medical school. All four did their medicine clerkship at a large county hospital (P < 0.02; odds ratio = 16.4) that had few infection control measures in place for tuberculosis isolation during the time of their exposure.


CONCLUSIONS
We recommend that medical students, as well as other healthcare professions students, be educated about infection control practices and skin tested at least annually during clinical training years.
Wurtz
R
R
Division of Infectious Disease, Cook County Hospital, Chicago, IL 60612.
Fernandez
J
J
Jovanovic
B
B
D002641:Chicago; D005069:Evaluation Studies as Topic; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000592:standards*; D007407:Interviews as Topic; D012577:Schools, Medical; D013337:Students, Medical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014374:Tuberculin Test / Q000706:statistics & numerical data