Reports on HIV/AIDS: 1990

OCTOBER 12, 1990, MMWR, Vol. 39, No. 40, pp. 718-722
Nosocomial Transmission of Multidrug-Resistant Tuberculosis
to Health-Care Workers and HIV-lnfected Patients
in an Urban Hospital - Florida
From January through April 1990, tuberculin skin-test conversions* occurred
among eight health-care workers (HCWs) on a specialized ward for human immunodeficiency virus (HIV)-infected patients at a large urban hospital in Florida. In February
1990, hospital personnel initiated an investigation of possible nosocomial transmission of tuberculosis (TB) at the hospital. In May, the hospital laboratory reported that
the number of isolates of Mycobacterium tuberculosis resistant to multiple anti-TB
drugs had increased during 1989 (Figure 1). This report provides preliminary findings
from the ongoing investigation of possible nosocomial transmission of multidrugresistant TB (MDR-TB) at the hospital. The investigation is being conducted by the
hospital, the local health department, the Florida Department of Health and Rehabilitative Services, and CDC.
*Reaction of >10 mm to a Mantoux skin test using 5 tuberculin units of purified protein
derivative in a person who previously had no reaction.
FIGURE 1. Patients with drug-resistant Mycobacterium tuberculosis isolates at a
large urban hospital, by drug* susceptibility pattern and by month of first specimen
collection - Florida, January 1987-January 1990
14 1

12 -
10 -
S8 -o 6 -4 -2 -0 -
] Other
INH Resistance
r RIF Resistance
SINH and RIF Resistance

'J FMAMJ J ASOND'J FMAMJ J ASOND'J FMAMJ J ASOND'J
1987 1988 1989 1990
Month and Year First Specimen Collected
*INH =isoniazid; RIF= rifampin.

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