SETTING: Between October 1992 and February 1994, 33 cases of multidrug-resistant tuberculosis (MDR-TB) were diagnosed among patients infected by the human immunodeficiency virus (HIV) and hospitalised in an HIV ward in Milan, Italy. This outbreak was part of a much larger outbreak, begun in another hospital and probably transferred through a patient. OBJECTIVE: To evaluate risk factors for transmission and the effectiveness of infection control measures. DESIGN: 1) Active follow-up of exposed patients, 2) cohort study among HIV-infected patients exposed to MDR-TB cases before and after the implementation of control measures, 3) screening of close contacts of MDR-TB cases, and 4) molecular typing by restriction fragment length polymorphism (RFLP) analysis. RESULTS: The risk of MDR-TB was higher in patients with lower CD4+ lymphocyte percentages and longer duration of exposure. No difference in the daily risk was observed for in-patients vs day-hospital patients or by room distance from an infectious case. Of the 90 patients exposed before the implementation of infection control measures (i.e., October 1992-June 1993) 26 (28.9%) developed MDR-TB, whereas none of the 44 patients exclusively exposed after implementation developed MDR-TB, despite the continuing presence of infectious MDR-TB cases in the ward. CONCLUSION: Simple control measures were effective in significantly reducing nosocomial transmission among patients.
SETTING: Between October 1992 and February 1994, 33 cases of multidrug-resistant tuberculosis (MDR-TB) were diagnosed among patients infected by the human immunodeficiency virus (HIV) and hospitalised in an HIV ward in Milan, Italy. This outbreak was part of a much larger outbreak, begun in another hospital and probably transferred through a patient. OBJECTIVE: To evaluate risk factors for transmission and the effectiveness of infection control measures. DESIGN: 1) Active follow-up of exposed patients, 2) cohort study among HIV-infectedpatients exposed to MDR-TB cases before and after the implementation of control measures, 3) screening of close contacts of MDR-TB cases, and 4) molecular typing by restriction fragment length polymorphism (RFLP) analysis. RESULTS: The risk of MDR-TB was higher in patients with lower CD4+ lymphocyte percentages and longer duration of exposure. No difference in the daily risk was observed for in-patients vs day-hospital patients or by room distance from an infectious case. Of the 90 patients exposed before the implementation of infection control measures (i.e., October 1992-June 1993) 26 (28.9%) developed MDR-TB, whereas none of the 44 patients exclusively exposed after implementation developed MDR-TB, despite the continuing presence of infectious MDR-TB cases in the ward. CONCLUSION: Simple control measures were effective in significantly reducing nosocomial transmission among patients.
Authors: A Krüüner; S E Hoffner; H Sillastu; M Danilovits; K Levina; S B Svenson; S Ghebremichael; T Koivula; G Källenius Journal: J Clin Microbiol Date: 2001-09 Impact factor: 5.948
Authors: J E Farley; C Tudor; M Mphahlele; K Franz; N A Perrin; S Dorman; M Van der Walt Journal: Int J Tuberc Lung Dis Date: 2012-01 Impact factor: 2.373
Authors: Aaron S Karat; Meghann Gregg; Hannah E Barton; Maria Calderon; Jayne Ellis; Jane Falconer; Indira Govender; Rebecca C Harris; Mpho Tlali; David A J Moore; Katherine L Fielding Journal: Clin Infect Dis Date: 2021-01-23 Impact factor: 9.079
Authors: Pablo E Campos; Pedro G Suarez; Jorge Sanchez; David Zavala; Jorge Arevalo; Eduardo Ticona; Charles M Nolan; Thomas M Hooton; King K Holmes Journal: Emerg Infect Dis Date: 2003-12 Impact factor: 6.883