Improved tuberculosis infection control practices in Maryland acute care hospitals

Background: In 1992 and 1993, the Maryland Hospital Association and the Mar yland Department of Health and Mental Hygiene conducted 2 surveys of tuberc ulosis prevention practices in Maryland hospitals that showed poor complian ce with the 1990 Centers for Disease Control and Prevention's guidelines fo r preventing transmission of tuberculosis in health care facilities. Objective: The objective of this study was to assess compliance in 1997 wit h the Centers for Disease Control and Prevention's guidelines in Maryland a cute care hospitals. Methods: A written questionnaire with 3 components-Infection Control, Emplo yee Health, and Microbiology Laboratory-was mailed to 56 Maryland acute car e hospitals. Results: Seventy-three percent of the surveys were returned. One hundred pe rcent of responding hospitals with tuberculosis isolation rooms reported ne gative pressure ventilation, 6 air exchanges per hour, and air exhausted to the outside or through high-efficiency particulate air filters. One hundre d percent of the responding hospitals reported providing National Institute for Occupational Safety and Health-approved respiratory protection for hea lth care workers; this compared with 24% in 1992 (P < .01). One hundred per cent of the responding hospitals reported performing at least annual tuberc ulin skin testing; this compared with 50% in 1992 (P < .01). Conclusions: The survey results demonstrate excellent compliance with the 1 994 Centers for Disease Control and Prevention recommendations for tubercul osis control in Maryland acute care hospitals, even in those facilities det ermined to be at minimal to low risk for tuberculosis exposure. The propose d Occupational Safety and Health Administration regulations are unlikely to further reduce the risk of tuberculosis exposure to health care workers in Maryland acute care hospitals.