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ABSTRACT
Introduction.
Hospital transmission of Mycobacterium tuberculosis (TB) is a
problem in US facilities where adults are treated. However, specific
guidelines for facilities in which pediatric patients are cared for
have never been defined, nor has any study attempted to assess
pediatric health care worker ( HCW) compliance with TB infection
control (IC) guidelines.
Methods. An observational study was
performed in two pediatric inpatient hospitals form May, 1996, to
December, 1997. A trained observer tallied persons (i.e.professional
HCWs, and non-HCWs) entering and leaving occupied TB isolation rooms
and recorded adherence with IC practices(e.g.proper use of
respirators, prompt door closures, door signage).
Results. Thirty children with
confirmed or suspected TB were admitted during the study period and
observed for a total of 242 h during which 656 visits by
professional (n=391) and ancillary (n=131) HCWs and by family
members (n=134) were recorded. During 30% of visits doors remained
open an average of 10 min, and during 20% of visits no repiratory
protection was worn. In all, visitors wore the correct respiratory
protection appropriately only 55% of the time. HCWs were more likely
to wear respiratory protection when caring for children with a
positive acid-fast bacillus smear than family members, but
professional staff were no more likely than anacillary staff to do
so.
Conclusions. This is the first
study to quantify compliance with IC practices for TB in pediatric
hospitals. The majority of visitors entering TB isolation rooms
ocupied by children with confirmed or suspected TB complied with IC
guidelines, but discrepancies were seen. Rather than relying on TB
IC guidelines designed for adult facilities, guidelines specific for
pediatric facilities that consider the local epidemiology of TB
should be developed.
Pediatr Infect Dis J, 2001;20:566-70
Copyright 2001 by Lippincott Williams &Wilkins, Inc. | 
