NOSOCOMIAL INFECTION WITH MULTIDRUG-RESISTANT AND MULTIDRUG-SUSCEPTIBLE TUBERCULOSIS IN 91 HEALTH-CARE WORKERS

Ninety-one health care workers (HCWs) employed in a public hospital were identified with recent tuberculin skin test conversion, Nosocomial transmission of rifampin-isoniazid-streptomycin-ethambutol (RISE)-resistant tuberculosis had occurred during a 10-month period. Rates of conversion differed significantly among physicians and nurses when compared with other personnel and were more frequent among physicians and nurses assigned to the medical service than among nurses and physicians assigned to nonmedical patient care or among other personnel, Among the 91 skin test converters were 15 of 21 HCWs assigned to an inpatient AIDS unit and 76 of 2282 HCWs assigned to other areas of the hospital. No cases oi active tuberculosis developed among these HCWs during the study period. These data strongly suggest RISE-resistant tuberculosis transmission, probably to workers assigned to the inpatient AIDS unit. Physicians and nurses assigned to the medical service were at greatest risk, but physicians were the group least likely to comply with tuberculin skin testing.