Effective screening tool to triage recovery rooms for possible tuberculosis patients undergoing bronchoscopy
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.
Document Type: Research Article
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
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