Progress of US hospitals in implementing TB control programs.

The CDC reported the results of two surveys of US hospitals conducted in 1992 and 1996 to determine the degree of implementation of the “CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis at US Hospitals.” The 1992 survey included all public (city, county, Veterans’ Administration), and primary medical school-affiliated US hospitals (n=632) and a 20% random sample of all private hospitals (n=444 with >100 beds. In 1996, a 50% random sample of (n=136) of all 1992 respondent hospitals with >6 TB admissions were resurveyed. Of the 1,076 hospitals surveyed in 1992, 763 (71%) of respondents returned a completed questionnaire. Among these, 536 (71%) of 755 reported having isolation rooms that met the CDC criteria for acid-fast bacilli (AFB) isolation rooms, ie, negative pressure, >6 air exchanges per hour, and air directly vented to the outside. The number of AFB isolation rooms that met the CDC criteria ranged from 0 to >60 (median, 7). The predominant form of respiratory protection was a nonfitted surgical mask. Almost all (747 [99%] of 758) respondents had some form of skin testing screening for healthcare workers. In the 1996 resurvey, 103 (75%) of 136 respondents returned a completed questionnaire. Of these, 99 (86%) of 103 reported having rooms that met the CDC criteria for AFB isolation, and the number of such rooms ranged from 0 to 74 (median, 12). Most (84 [82%] of 103) respondents had N95 respiratory protective devices for healthcare workers. In 1996, all respondents had tuberculin skin testing (TST) programs; however, only 30 (29%) of 103 could provide TST data for 1992 to 1996. The authors concluded that US hospitals are making significant progress in the implementation of specific recommendations for preventing transmission of M tuberculosis. However, management of TST data remains a challenge for hospital personnel, and continued improvement is needed to implement the CDC’s TB guidelines fully. FROM: Manangan LP, Pugliese G, Rudnick JR, Banerjee SN, Kroc K, Steingraber K, et al. Are US hospitals making significant progress in implementing guidelines for prevention of Mycobacterium tuberculosis transmission? Presented at the 35th Annual Meeting of the Infectious Diseases Society of America; September 13-16, 1997; San Francisco, CA. Abstract no. 331.