Skin testing for tuberculosis in university teaching hospitals--is there a problem?

We performed four annual audits of tuberculin tests performed on hospitalized patients at a university teaching hospital complex. Each audit assessed if tests were performed and read correctly. House staff performed skin testing in years 1 to 3. Despite interventions of teaching and then of written instructions on skin testing, performance was poor. When testing was turned over in year 4 to trained infection control practitioners, performance approached 100%. We conclude that university teaching hospitals should assess skin-testing performance.