Administrative measures for preventing Mycobacterium tuberculosis infection among healthcare workers in a teaching hospital in Rio de Janeiro, Brazil

Summary Tuberculosis (TB) is an occupational disease of healthcare workers (HCWs). Administrative and engineering interventions simultaneously implemented in hospitals of developed countries have reduced the risk of nosocomial transmission of M. tuberculosis . We studied the impact of administrative...

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Published in:	The Journal of hospital infection Vol. 72; no. 1; pp. 57 - 64
Main Authors:	Albuquerque da Costa, P, Trajman, A, Carvalho de Queiroz Mello, F, Goudinho, S, Monteiro Vieira Silva, M.A, Garret, D, Ruffino-Netto, A, Lineu Kritski, A
Format:	Journal Article
Language:	English
Published:	Kidlington Elsevier Ltd 01-05-2009 Elsevier
Subjects:	Adult Bacterial diseases Biological and medical sciences Brazil Cross Infection - microbiology Cross Infection - prevention & control Cross Infection - transmission Female General aspects Health Education Health Personnel Hospitals, Teaching Human bacterial diseases Human infectious diseases. Experimental studies and models Humans Infection control Infection Control - methods Infectious Disease Infectious diseases Male Medical sciences Middle Aged Mycobacterium tuberculosis Mycobacterium tuberculosis - isolation & purification Nosocomial infection Occupational Diseases - microbiology Occupational Diseases - prevention & control Occupational exposure Patient Isolation Sputum - microbiology Tuberculin Test Tuberculosis Tuberculosis - diagnosis Tuberculosis - microbiology Tuberculosis - prevention & control Tuberculosis - transmission Tuberculosis and atypical mycobacterial infections South America Brazil America Brazil, Rio de Janeiro Nosocomial infection Tuberculin test Tuberculosis Health personnel Occupational exposure Infection control Teaching hospital Check Health care staff Mycobacterial infection Tuberculin Infection Prevention Work safety Mycobacterium tuberculosis Mycobacteriales Bacteriosis Mycobacteriaceae Bacteria Actinomycetes Occupational medicine Public health
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Summary:	Summary Tuberculosis (TB) is an occupational disease of healthcare workers (HCWs). Administrative and engineering interventions simultaneously implemented in hospitals of developed countries have reduced the risk of nosocomial transmission of M. tuberculosis . We studied the impact of administrative infection control measures on the risk for latent TB infection (LTBI) among HCWs in a resource-limited, high-burden country. An intervention study was undertaken in a university-affiliated, inner-city hospital in Rio de Janeiro, where routine serial tuberculin skin testing (TST) is offered to all HCWs. From October 1998 to February 2001, the following infection control measures were progressively implemented: isolation of TB suspects and confirmed TB inpatients, quick turnaround for acid-fast bacilli sputum tests and HCW education in use of protective respirators. Among 1336 initially tested HCWs, 599 were retested. The number of TST conversions per 1000 person-months during and after the implementation of these measures was reduced from 5.8/1000 to 3.7/1000 person-months ( P = 0.006). The most significant reductions were observed in the intensive care unit (from 20.2 to 4.5, P < 0.001) and clinical wards (from 10.3 to 6.0, P < 0.001). Physicians and nurses had the highest reductions (from 7.6 to 0, P < 0.001; from 9.9 to 5.8, P = 0.001, respectively). We conclude that administrative measures for infection control can significantly reduce LTBI among HCWs in high-burden countries and should be implemented even when resources are not available for engineering infection control measures.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0195-6701 1532-2939
DOI:	10.1016/j.jhin.2009.01.016