Multi-resistant tuberculosis among South African health care workers

January 01, 0001

Multi-resistant tuberculosis among South African health care workers

Nosocomial transmission has been described in extensively drug- resistant tuberculosis (XDR-TB) and HIV co-infected patients in South Africa. These investigators from multiple countries estimated rates of multidrug- resistant tuberculosis (MDR-TB) and XDR-TB hospitalizations among health care workers in KwaZulu-Natal, South Africa in a retrospective study of patients with drug-resistant tuberculosis who were admitted from 2003 to 2008 for the initiation of drug-resistant tuberculosis therapy. They included 231 health care workers and 4151 non-health care workers admitted for initiation of MDR- TB or XDR-TB treatment.

They found: "Estimated incidence of MDR-TB hospitalization was 64.8 per 100,000 health care workers versus 11.9 per 100,000 non-health care workers (incidence rate ratio, 5.46). Estimated incidence of XDR-TB hospitalizations was 7.2 per 100,000 health care workers versus 1.1 per 100,000 non-health care workers (incidence rate ratio, 6.69). A higher percentage of health care workers than non-health care workers with MDR-TB or XDR-TB were women (78% vs. 47%), and health care workers were less likely to report previous tuberculosis treatment (41% vs. 92%). HIV infection did not differ between health care workers and non-health care workers (55% vs. 57%); however, among HIV-infected patients, a higher percentage of health care workers were receiving antiretroviral medications (63% vs. 47%)."

The authors concluded: "Health care workers in this HIV-endemic area were substantially more likely to be hospitalized with either MDR-TB or XDR-TB than were non-health care workers. The increased risk may be explained by occupational exposure, underlining the urgent need for tuberculosis infection-control programs."

Occupational exposure of health care workers to tuberculosis and subsequent infections with multi-resistant strains is a concern of global public health interest.

For the full abstract, click here.

Annals of Internal Medicine 153(8):516-522, 19 October 2010 © 2010 to the American College of Physicians
High Incidence of Hospital Admissions With Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis Among South African Health Care Workers. Max R. O'Donnell, Julie Jarand, Marian Loveday, et al. Correspondence to Dr. O’Donnell: [email protected]

Category: GH. Global Health. Keywords: tuberculosis, drug resistance, health care workers, occupational exposure, retrospective cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 9 November 2010

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