Manangan L P, Simonds D N, Pugliese G, Kroc K, Banerjee S N, Rudnick J R, Steingraber K, Jarvis W R
Hospital Infections Program, National Center for Infectious Diseases, and Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Arch Intern Med. 1998 Jul 13;158(13):1440-4. doi: 10.1001/archinte.158.13.1440.
Outbreaks of tuberculosis (TB) in hospitals have occurred when the Centers for Disease Control and Prevention (CDC) guideline recommendations for preventing the transmission of Mycobacterium tuberculosis were not fully implemented.
To determine whether US hospitals are making progress in implementing the CDC guidelines for preventing TB.
In 1992, we surveyed all public (city, county, Veterans Affairs, and primary medical school-affiliated) US hospitals (n = 632) and 444 (20%) random samples of all private hospitals with 100 beds or more. In 1996, we resurveyed 136 random samples (50%) of all 1992 respondent hospitals with 6 or more TB admissions in 1991.
Of the 1076 hospitals surveyed in 1992, 763 (71%) respondents returned a completed questionnaire. Among these, 536 (71%) of 755 reported having rooms that met CDC criteria for acid-fast bacilli isolation, ie, negative air pressure, 6 or more air exchanges per hour, and air directly vented to the outside. The predominant respiratory protective device for health care workers was nonfitted surgical mask and attending physicians were infrequently (50%) included in tuberculin skin-testing programs. In the 1996 resurvey, 103 (76%) of 136 respondents returned a completed questionnaire. Of these, 99 (96%) reported having rooms that met CDC criteria for acid-fast bacilli isolation. The N95 respiratory protective devices were predominantly used by health care workers, and attending physicians were increasingly (69%) included in the hospitals' tuberculin skin-testing programs.
Most US hospitals are making progress in the implementation of CDC guidelines for preventing the transmission of M tuberculosis.
当疾病控制与预防中心（CDC）关于预防结核分枝杆菌传播的指南建议未得到充分实施时，医院就会发生结核病（TB）暴发。
确定美国医院在实施CDC预防结核病指南方面是否取得进展。
1992年，我们对美国所有公立（市、县、退伍军人事务部以及医学院附属医院）医院（n = 632）以及444家（占所有100张床位及以上私立医院的20%）随机抽取的私立医院进行了调查。1996年，我们对1992年所有有6例及以上1991年结核病入院病例的应答医院中的136家（占50%）进行了再次调查。
在1992年调查的1076家医院中，763家（71%）应答者返回了完整的问卷。其中，755家医院中的536家（71%）报告有符合CDC耐酸杆菌隔离标准的病房，即负压、每小时6次及以上换气次数以及空气直接排至室外。医护人员主要的呼吸防护设备是非贴合式外科口罩，且主治医师很少（50%）被纳入结核菌素皮肤检测项目。在1996年的再次调查中，136家应答者中的103家（76%）返回了完整的问卷。其中，99家（96%）报告有符合CDC耐酸杆菌隔离标准的病房。医护人员主要使用N95呼吸防护设备，且主治医师越来越多地（69%）被纳入医院的结核菌素皮肤检测项目。
大多数美国医院在实施CDC预防结核分枝杆菌传播指南方面取得了进展。
