Tuberculosis in hemodialysis patients in New Jersey: a statewide study.
OBJECTIVE
To study the incidence of tuberculosis (TB), tuberculin skin testing (TST) practices, and infection control practices at outpatient hemodialysis centers.


METHODS
Mail surveys performed in December 1994 and 1995.


METHODS
The numbers of patients with incident active TB during 1994 and 1995, TST policies during 1994, and TB infection control policies in 1994.


METHODS
All outpatient dialysis centers in New Jersey.


METHODS
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).


CONCLUSIONS
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.
Simon
T A
TA
New Jersey University of Medicine and Dentistry, Trenton, USA.
Paul
S
S
Wartenberg
D
D
Tokars
J I
JI
D000488:Allied Health Personnel; D006436:Hemodialysis Units, Hospital; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000592:standards*; D009515:New Jersey / Q000453:epidemiology; D011159:Population Surveillance; D011795:Surveys and Questionnaires; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*