Latent tuberculosis infection screening in Minnesota's critical access hospitals

The prevalence of tuberculosis (TB) declined worldwide during most of the 20th century. However, between 1980 and 1990, the incidence rate rose. Subsequently, the United States, through the Centers for Disease Control and Prevention (CDC), and the United Nations increased efforts to control TB and reduce its burden on population health. One of those efforts has been offering guidance about screening health care workers. This article reports on the findings of an investigation into whether Critical Access Hospitals in Minnesota are following the CDC guidelines for screening and treatment for latent tuberculosis infection. Among the findings, 97% of the hospitals used the two-step tuberculosis skin test (TST) as their baseline test, 29% screened only on hire and 71% screened annually. Our study also found many hospitals do not follow CDC recommendations for TST administration or interpretation, nor do all hospitals refer individuals with positive test results for treatment.