BACKGROUND: An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms. OBJECTIVE: To identify risk factors for transmission of Mycobacterium tuberculosis. DESIGN: Retrospective cohort study. SETTING: Private hospital. PARTICIPANTS: Patients and health care workers exposed to M. tuberculosis. MEASUREMENTS: Analysis of M. tuberculosis isolates, tuberculin skin testing, assessment of exposure, and assessment of participant characteristics. RESULTS: All seven M. tuberculosis isolates had matching DNA fingerprints. Of patients exposed to M. tuberculosis, those who developed tuberculosis had lower CD4+ T-lymphocyte counts (P = 0.02) and were more likely to be ambulatory (P = 0.03) than those who did not. Of 74 exposed health care workers, the 11 (15%) who had conversion on tuberculin skin testing were no more likely than those who did not have conversion to report that they always wore a respirator with a high-efficiency particulate air filter. CONCLUSIONS: Transmission of M. tuberculosis occurred in a hospital that did not have recommended isolation rooms. A respirator-fit testing program did not protect health care workers in this setting.
BACKGROUND: An outbreak of seven cases (in six patients and one health care worker, all of whom had AIDS) of multidrug-resistant tuberculosis occurred in a hospital in Chicago. The hospital had a respirator-fit testing program but no acid-fast bacilli isolation rooms. OBJECTIVE: To identify risk factors for transmission of Mycobacterium tuberculosis. DESIGN: Retrospective cohort study. SETTING: Private hospital. PARTICIPANTS: Patients and health care workers exposed to M. tuberculosis. MEASUREMENTS: Analysis of M. tuberculosis isolates, tuberculin skin testing, assessment of exposure, and assessment of participant characteristics. RESULTS: All seven M. tuberculosis isolates had matching DNA fingerprints. Of patients exposed to M. tuberculosis, those who developed tuberculosis had lower CD4+ T-lymphocyte counts (P = 0.02) and were more likely to be ambulatory (P = 0.03) than those who did not. Of 74 exposed health care workers, the 11 (15%) who had conversion on tuberculin skin testing were no more likely than those who did not have conversion to report that they always wore a respirator with a high-efficiency particulate air filter. CONCLUSIONS: Transmission of M. tuberculosis occurred in a hospital that did not have recommended isolation rooms. A respirator-fit testing program did not protect health care workers in this setting.
Authors: Guang Xue He; Hai Ying Wang; Martien W Borgdorff; Dick van Soolingen; Marieke J van der Werf; Zhi Min Liu; Xue Zheng Li; Hui Guo; Yan Lin Zhao; Jay K Varma; Christopher P Tostado; Susan van den Hof Journal: Emerg Infect Dis Date: 2011-10 Impact factor: 6.883
Authors: P Bifani; B Mathema; M Campo; S Moghazeh; B Nivin; E Shashkina; J Driscoll; S S Munsiff; R Frothingham; B N Kreiswirth Journal: Emerg Infect Dis Date: 2001 Sep-Oct Impact factor: 6.883
Authors: Roula S Zahr; Ryan A Peterson; Linnea A Polgreen; Joseph E Cavanaugh; Douglas B Hornick; Kevin L Winthrop; Philip M Polgreen Journal: BMJ Open Diabetes Res Care Date: 2016-10-10
Authors: Guang Xue He; Susan van denHof; Marieke J van der Werf; Guo Jie Wang; Shi Wen Ma; Dong Yang Zhao; Yuan Lian Hu; Shi Cheng Yu; Martien W Borgdorff Journal: BMC Infect Dis Date: 2010-10-28 Impact factor: 3.090
Authors: Claude Rutanga; David W Lowrance; John E Oeltmann; Grace Mutembayire; Matt Willis; Claude Bernard Uwizeye; Ruton Hinda; Chitou Bassirou; Steve Gutreuter; Michel Gasana Journal: PLoS One Date: 2015-04-28 Impact factor: 3.240
Authors: Aaron C Miller; Linnea A Polgreen; Joseph E Cavanaugh; Douglas B Hornick; Philip M Polgreen Journal: Open Forum Infect Dis Date: 2015-12-19 Impact factor: 3.835