IMPLEMENTING A TUBERCULOSIS-CONTROL PROGRAM

Between January 1989 and December 1990, 26 patients acquired multidrug -resistant tuberculosis at our institution. Their exposures occurred w hen they were admitted to a ward where a patient with acid fast bacill us smear-positive pulmonary tuberculosis was also admitted. In 20 case s, the infectious patients were not isolated until the sputum smears w ere positive. When the outbreak was recognized in the spring of 1990, the infection control department undertook a risk assessment and insti tuted measures that would become the tuberculosis control program. Sin ce then, administrative and environmental controls have been implement ed, education programs are ongoing, personal protective equipment is i n use, and a more aggressive employee health testing program is underw ay. The steps we took and the barriers we had to overcome to implement our plan are included in this article.