First Documented Human Rickettsia aeschlimannii Infection

748 Emerging Infectious Diseases • Vol. 8, No. 7, July 2002 Additionally, the high conversion rate (two of five) in those who reported consistent mask use when caring for active TB cases may suggest overreporting of mask use, poor adjustment of the mask, contact with unsuspected active cases (9), or contact with a contaminated environment. This high TST conversion rate and incidence of TB demonstrate the inadequacy of hospital infection control measures. In Peru, both unsuspected active TB and multidrug-resistant TB are highly prevalent (9). Rapid detection and respiratory isolation of patients with active or suspected TB are rarely practiced. In conclusion, Peruvian physicians have an extremely high risk of TST conversion and active TB. Hospitals in developing countries need to design and implement effective and appropriate infection control measures such as appropriate mask usage, sputum testing, and rapid reporting of MTB smears of all patients with respiratory symptoms, as well as respiratory control for smear-positive TB cases (10).