Factors influencing purified protein derivative (PPD) skin test conversion among hospital employees were examined. The impetus for the study was an increase in the incidence of PPD skin test conversions seen among employees at a university teaching hospital in New York State between 1991 and 1993. This coincided with a change in the employee health services tuberculosis (TB) screening policy for persons with previous bacille Calmette-Guerin (BCG) vaccination. The medical records of all employees who had PPD test conversions between 1988 and 1993 were reviewed to identify possible factors that could have influenced conversion. The authors conclude that a large proportion of PPD skin test conversions in workers who have received BCG vaccination may not represent active TB, but may reflect BCG vaccination. A two step PPD skin test protocol may help eliminate false positive PPD skin test conversions.
American Journal of Infection Control, 23(3):181-187, 1995. (22 references)
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