TY - JOUR
T1 - Pulmonary tuberculosis
T2 - An analysis of isolation practices and clinical risk factors in a tertiary hospital
AU - Thiruvengadam, Srivathsan
AU - Giudicatti, Lauren
AU - Maghami, Siaavash
AU - Farah, Hussein
AU - Waring, Justin
AU - Waterer, Grant
AU - Perera, Kumaraweerage Ruad Herman
PY - 2019/10
Y1 - 2019/10
N2 - Background: Inadequate isolation of patients with active pulmonary tuberculosis causes exposure whereas over-cautious isolation generates time and cost inefficiencies. This study aims to ascertain the delays involved in isolating subjects and the importance of risk factors. Methods and material: Between December 2010 and January 2013, a retrospective analysis of 271 subjects was performed. Information was obtained from discharge letters, radiological and microbiological results. Results: The median time taken to isolate subjects was 0 days, and 71.7% were isolated within 1 day. Most subjects (75.3%) had sputum samples obtained after isolation, of which 14.7% were positive. The median time from admission to first sputum sample was 1 day. Smear was negative in 174 subjects (85.3%). Country of birth (high or low risk) did not significantly affect sputum positivity (25.5% vs 19.4%, p = 0.52). Suspicious radiological findings were noted in 38.6% subjects, and 32.8% had a suspicious clinical history. Subjects with both clinical and radiological probability had more sputum positivity (46.2%), compared to subjects who had neither (2.7%). Conclusion: There are delays with isolation and diagnosis of subjects with a high probability of tuberculosis. Clinical and radiological probability were more significant in predicting sputum positivity than country of birth.
AB - Background: Inadequate isolation of patients with active pulmonary tuberculosis causes exposure whereas over-cautious isolation generates time and cost inefficiencies. This study aims to ascertain the delays involved in isolating subjects and the importance of risk factors. Methods and material: Between December 2010 and January 2013, a retrospective analysis of 271 subjects was performed. Information was obtained from discharge letters, radiological and microbiological results. Results: The median time taken to isolate subjects was 0 days, and 71.7% were isolated within 1 day. Most subjects (75.3%) had sputum samples obtained after isolation, of which 14.7% were positive. The median time from admission to first sputum sample was 1 day. Smear was negative in 174 subjects (85.3%). Country of birth (high or low risk) did not significantly affect sputum positivity (25.5% vs 19.4%, p = 0.52). Suspicious radiological findings were noted in 38.6% subjects, and 32.8% had a suspicious clinical history. Subjects with both clinical and radiological probability had more sputum positivity (46.2%), compared to subjects who had neither (2.7%). Conclusion: There are delays with isolation and diagnosis of subjects with a high probability of tuberculosis. Clinical and radiological probability were more significant in predicting sputum positivity than country of birth.
KW - Acid fast bacilli
KW - Active
KW - Cost-effective
KW - Isolation
KW - Pulmonary tuberculosis
KW - Sputum samples
UR - http://www.scopus.com/inward/record.url?scp=85049923331&partnerID=8YFLogxK
U2 - 10.1016/j.ijtb.2018.04.013
DO - 10.1016/j.ijtb.2018.04.013
M3 - Article
C2 - 31813429
AN - SCOPUS:85049923331
SN - 0019-5707
VL - 66
SP - 437
EP - 442
JO - Indian Journal of Tuberculosis
JF - Indian Journal of Tuberculosis
IS - 4
ER -