Tuberculin skin testing surveillance of health care personnel.
To estimate the incidence of and assess risk factors for occupational Mycobacterium tuberculosis transmission to health care personnel (HCP) in 5 New York City and Boston health care facilities, performance of prospective tuberculin skin tests (TSTs) was conducted from April 1994 through October 1995. Two-step testing was used at the enrollment of 2198 HCP with negative TST results. Follow-up visits were scheduled for every 6 months. Thirty (1.5%) of 1960 HCP with >/=1 follow-up evaluation had TST conversion (that is, an increase in TST induration of >/=10 mm). Independent risk factors for TST conversion were entering the United States after 1991 and inclusion in a tuberculosis-contact investigation in the workplace. These findings suggest that occupational transmission of M. tuberculosis occurred, as well as possible nonoccupational transmission or late boosting among foreign-born HCP who recently entered the United States. These results demonstrate the difficulty in interpreting TST results and estimating conversion rates among HCP, especially when large proportions of foreign-born HCP are included in surveillance.
Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA. Apanlilio@cdc.gov
Adelisa L
AL
Panlilio
Dale R
DR
Burwen
Amy B
AB
Curtis
Pamela U
PU
Srivastava
John
J
Bernardo
Michela T
MT
Catalano
Meryl H
MH
Mendelson
Peter
P
Nicholas
William
W
Pagano
Carol
C
Sulis
Ida M
IM
Onorato
Mary E
ME
Chamberland
D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis; D011159:Population Surveillance; D011446:Prospective Studies; D012307:Risk Factors; D014374:Tuberculin Test; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission