Nosocomial tuberculosis prevention measures among two groups of US hospitals, 1992 to 1996.
OBJECTIVE
To compare trends in nosocomial tuberculosis (TB) prevention measures and health-care worker (HCW) tuberculin skin test (TST) conversion of hospitals with HIV-related Pneumocystis carinii pneumonia (PCP) patients and other US hospitals from 1992 through 1996.


METHODS
Surveys in 1992 and 1996 of 38 hospitals with PCP patients in four high-HIV-incidence cities and 136 other US hospitals from the American Hospital Association membership list.


METHODS
Twenty-seven hospitals with PCP patients and 103 other US hospitals.


RESULTS
In 1992, 63% of PCP hospitals and other US hospitals had rooms meeting Centers for Disease Control and Prevention (CDC) criteria (ie, negative air pressure, six or more air exchanges per hour, and air directly vented to the outside) for acid-fast bacilli isolation; in 1996, almost 100% had such isolation rooms. Similarly, in 1992, nonfitted surgical masks were used by HCWs at 60% of PCP hospitals and 68% at other US hospitals, while N95 respirators were used at 90% of PCP hospitals and 83% of other US hospitals in 1996. There was a significant decreasing trend in TST conversion rates among HCWs at both PCP and other US hospitals; however, this trend varied among all hospitals. HCWs at PCP hospitals had a higher risk of TST conversion than those at other US hospitals (relative risk, 1.71; p < 0.0001).


CONCLUSIONS
From 1992 through 1996, PCP and other US hospitals have made similar improvements in their nosocomial TB prevention measures and decreased their HCW TST conversion rate. These data show that most hospitals are compliant with CDC TB guidelines even before the enactment of an Occupational Safety and Health Administration TB standard.
Manangan
L P
LP
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. lpm2@cdc.gov
Bennett
C L
CL
Tablan
N
N
Simonds
D N
DN
Pugliese
G
G
Collazo
E
E
Jarvis
W R
WR
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control* / Q000635:transmission; D003140:Communicable Disease Control / Q000639:trends*; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D005544:Forecasting; D006786:Hospitals, Urban / Q000639:trends; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D010356:Patient Isolation / Q000639:trends; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control / Q000635:transmission; D012307:Risk Factors; D014374:Tuberculin Test; D018088:Tuberculosis, Multidrug-Resistant / Q000517:prevention & control* / Q000635:transmission; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control* / Q000635:transmission; D014481:United States; D014691:Ventilation