TUBERCULOSIS SKIN-TEST CONVERSION AMONG HEALTH-CARE WORKERS AT A MILITARY MEDICAL-CENTER

Health care workers (HCW) are at risk of occupationally acquiring Myco bacterium tuberculosis (TB) infection, The Centers for Disease Control and Prevention has published guidelines for health care facilities to protect HCW, One of the recommended elements is TB infection surveill ance among HCW using purified protein derivative (PPD) skin testing an d analysis of the data by occupational group and work location to dete rmine areas of increased risk of infection, At the military medical ce nter (MMC) we studied, occupational groups with statistically signific ant (p < 0.05) above-average PPD conversion risk (>1.1%/year) included respiratory therapists (15.6%/year), nursing technicians (2.3%/year), and military personnel (1.6%/year), Maintenance and engineering worke rs (2.6%/year), food service workers (2.5%/year), laboratory workers ( 2.0%/year), custodial workers (1.8%/year), and practical nurses (1.7%/ year) had above-average, but not statistically significant, risk, The fourth floor of the MMC had 39% (21/54) of the converters, The surveil lance program also uncovered 235 individuals who had not completed ade quate prophylactic therapy, and a case of active TB in a laboratory wo rker.