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  • Jurnal Inggris Hiv 1

    Diunggah oleh

    Rista Hernidawati
    9 tayangan6 halaman
    hiv

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    hiv

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai PDF atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    9 tayangan6 halaman

    Jurnal Inggris Hiv 1

    Diunggah oleh

    Rista Hernidawati
    hiv

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai PDF atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 6
    Hospital Outbreak of Multidrug-Resistant Mycobacterium tuberculosis Infections Factors in Transmission to Staff and HIV-Infected Patients ‘Consuelo Beck Sagué, MD; Samuel W. Dooley, MD; Mary D. Hutton, RN, MPH; Joan Oiten, RN; Alma Breeden, RN, Jack T. Crawlord, PhD: Arthur E. Pitchenik, MD: Charles Woodley, PhD; George Cauthen, PhO; Wiliam A Jarvis, MD ‘Objective.—To describe transmission of multidrug-resistant (MOR) Mycobacto- ‘ium tuberculosis infection among patients and health care workers (HCWs) in & Ward and clinic for human immunodeficiency virus (HIV)-infected patients in a hospital, four studies were conducted. ‘Methiods.—Case patients and control patients were persons who had been treated in the HIV ward or clinic, whose clinical course was consistent with tuber- ‘culosis and who had at east one positive culture for M tuberculosis between Jan- vary 1, 1988, and January 31, 1990, resistantto at leastisoniazid and rifampin (case Patients), or whose isolates were susceptible to all drugs tested (contro patients). In the frst study, case patients and control patients were compared to identi risk {factors for MDR tuberculos's. In the second study, inpationt and outpatient days of MDR tuberoulosis case patients were compared to determine whether acid-fast bacilus (AFB) smear-positvity or aorosolized pontamiino use was associated with higher numbers of subsequent MOR tuberculosis cases among exposed patients. {nthe third study, restriction fragment length polymorphism analysis was performed ‘onavailable MDR and sensitive M tuberculosisisolates. inthe fourth study, skin test ‘conversion rates among HCWs in the HIV ward and clinic were compared with those of HOWs in another ward, and the strength of the associations betwen skin test conversions among HCWs on the HIV ward and the number of person-days that AFB smear-positive case patients and control patients were on this ward was, estimated. Results. —Case patients were more likely than control patients tohaave been ex- posed on the HIV ward or clinic to an AFB smear-positive case patient (P <.001). Inpatient and outpatient days of MDR tuberculosis case patients were associated with more subsequent cases of MDR tuberculosis if exposing case patients were ‘smear-positive or if they received aerosolized pentamidine (P=.01). Of 13 MDR 'solates, all had one of two restriction fragment length polymorphism pattems; 10 ‘sensitive isolates had restriction fragment length polymorphism pattems that were

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