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The occurrence of multidrug-resistant Mycobacterium tuberculosis (MDR/TB) outbreaks was reviewed and the efficiency of control measures implemented at three hospitals with MDR/TB outbreaks was described. Seven initial nosocomial MDR/TB outbreaks from 1989 to 1992 were investigated. The cases were resistant to isoniazid in all seven outbreaks, and in six cases rifampin was also ineffective. A major risk factor identified in the study was same ward exposure. At each hospital both the number of patients with MDR/TB and the proportion of patients with tuberculosis at the hospital with the MDR/TB outbreak strain decreased during the intervention period. The author concludes that there is an urgent need to evaluate the efficacy of the combined and individual components of current tuberculosis infection control measures. The goal of these efforts should be to terminate patient to patient and patient to health care worker tuberculosis transmission.
American Journal of Infection Control, 23(2):146-151, 1995. (17 references)
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