SHEA-CDC TB SURVEY .1. STATUS OF TB INFECTION-CONTROL PROGRAMS AT MEMBER HOSPITALS, 1989-1992

OBJECTIVE: To determine trends in Mycobacterium tuberculosis infection in healthcare workers, tuberculosis (TB) control measures, and compli ance with the 1990 Centers for Disease Control and Prevention (CDC) gu ideline for preventing transmission of TB in healthcare facilities. DE SIGN: Voluntary questionnaire sent to all members of the Society for H ealthcare Epidemiology of America, representing 359 hospitals. RESULTS : Respondents' hospitals (210 [58%]) had a median of 2,400 healthcare workers (range, 396 to 13,745), 437 beds (range, 48 to 1,250), 5.6 pat ients with TB per year (range, 0 to 499), and 0 multidrug-resistant (M DR) TB patients per year (range, 0 to 33). Of 166 respondents' hospita ls for which data were provided for 1989 through 1992, the number cari ng for MDR-TB patients increased from 10 (6%) in 1989 to 49 (30%) in 1 992. Reported policies for routine healthcare worker tuberculin skin t esting varied. The median skin-test positivity rate for healthcare wor kers at the time of hire increased from 0.54% in 1989 to 0.81% in 1992 , but the median conversion rate during routine testing remained simil ar: 0.35% in 1989 and 0.33% in 1992. Among 196 hospitals with reported data on respiratory protection use for 1989 through 1992, the use of either surgical submicron, dust-mist, or dust-fume-mist respirators fo r healthcare workers increased from 9 (5%) in 1989 to 85 (43%) in 1992 . Of 181 hospitals with reported data, 113 (62%) had acid-fast bacilli isolation facilities consistent with the 1990 CDC guideline (ie, a si ngle patient room, negative air pressure relative to the hallway, air exhausted directly outside, and greater than or equal to 6 air exchang es per hour). CONCLUSIONS: While the number of surveyed hospitals cari ng for TB and MDR-TB patients increased during 1989 through 1992, TB i nfection control measures at many hospitals still did not meet the 199 0 CDC guideline recommendations