Free Content Effective screening tool to triage recovery rooms for possible tuberculosis patients undergoing bronchoscopy

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Abstract:

SETTING: In 2005, tuberculin skin test conversions were observed following exposure to a patient with active pulmonary tuberculosis (TB) who recovered post-bronchoscopy in an open area at The Ottawa Hospital, Canada. In response, we implemented a screening tool to triage patients to an airborne infection isolation (AII) room pre- and post-bronchoscopy.

OBJECTIVE: To evaluate the performance of the screening tool in detecting patients with culture-confirmed TB.

DESIGN: All bronchoscopies performed between 1 March 2006 and 31 March 2010 were retrospectively reviewed.

RESULTS: Of 1839 patients included (55.3% of bronchoscopies), 210 screened positive, capturing 28 culture-confirmed TB cases. Three patients with positive TB cultures screened negative. The sensitivity of the screening tool was 90.3%; the negative predictive value was 99.8%. A positive screening result was strongly predictive of a positive TB culture.

CONCLUSIONS: The screening tool is effective for identifying high-risk patients and triaging them to AII rooms. The pre-bronchoscopy screening tool is simple and inexpensive to implement and has the potential to reduce intra-institutional spread of TB.

Keywords: Mycobacterium tuberculosis; infection control; nosocomial infections

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.11.0555

Affiliations: 1: Department of Infectious Diseases, Ottawa Hospital, Ottawa, Ontario, Canada 2: Department of Respirology, Ottawa Hospital, Ottawa, Ontario, Canada 3: Endoscopy Unit, Ottawa Hospital, Ottawa, Ontario, Canada 4: Department of Infection Control, Ottawa Hospital, Ottawa, Ontario, Canada

Publication date: May 1, 2012

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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