Nosocomial transmission of tuberculosis in a hospital unit for HIV-infected patients

Article Abstract:

HIV-infected patients are likely to develop tuberculosis (TB) if they are exposed to a patient who has TB. Health care workers who care for TB patients are also at risk of developing TB. Of 240 patients in an HIV unit in a large hospital, 17% of those exposed to a TB patient developed TB, but only two percent of those not exposed developed TB. Overall, the HIV patients exposed to a TB patient were 11 times more likely to develop TB than those who were not exposed. Of 908 health care workers tested for TB infection, nurses in the HIV unit were six times more likely to have a positive tuberculin test than clerical workers on another floor. Nurses in the internal medicine wards, which were on the same floor as the HIV unit, were also six times more likely to have a positive tuberculin test. HIV patients should be screened for TB and should be placed in isolation and treated if they are found to be infected. Health care workers should also be screened.

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Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections: factors in transmission to staff and HIV-infected patients

Article Abstract:

HIV-infected patients who are exposed to another patient with a positive acid-fast bacillus (AFB) sputum-smear may be more likely to develop a multidrug-resistant (MDR) tuberculosis infection. The prevalence of MDR tuberculosis may be higher among HIV-infected individuals than among other individuals. Among HIV-infected patients with tuberculosis who were treated at an HIV ward or clinic at a Florida hospital between Jan 1988 and Jan 1990, 25 developed a MDR tuberculosis infection and 62 developed a drug-susceptible tuberculosis infection. Patients with MDR tuberculosis were more likely to have been exposed to the sputum of a patient with an AFB-positive smear than those with a drug-susceptible infection. Among health care workers who worked in the HIV ward and clinic, the risk of a positive skin test for tuberculosis exposure increased with the amount of exposure to patients with positive AFB sputum.

Health aspects, Mycobacterium tuberculosis, Nosocomial infections, Cross infection

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The emergence of drug-resistant tuberculosis in New York City

Article Abstract:

The incidence of drug-resistant tuberculosis is increasing in New York City. Drug-resistant tuberculosis is caused by strains of Mycobacterium tuberculosis that are resistant to treatment with anti-tuberculosis drugs. Among 466 patients from New York City suffering from tuberculosis in Apr 1991, 33% were infected with a strain of Mycobacterium tuberculosis that was resistant to treatment with anti-tuberculosis drugs. Twenty-six percent of the patients were infected with a strain resistant to isoniazid, and 19% were infected with a strain resistant to both isoniazid and rifampin. Of the patients who had never been treated for tuberculosis before, those who were infected with HIV or who used intravenous drugs were more likely to be suffering from drug-resistant tuberculosis than the others. Prior treatment for tuberculosis was the largest risk factor for drug-resistant tuberculosis.

Statistics, New York, New York, New York

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