Cargando…

A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis

BACKGROUND: Effective protocols for the isolation and de-isolation of patients with suspected pulmonary tuberculosis (PTB) are essential determinants of health-care costs. Early de-isolation needs to be balanced with the need to prevent nosocomial transmission of PTB. The aim of our study was to eva...

Descripción completa

Detalles Bibliográficos
Autores principales: Kalimuddin, Shirin, Tan, Jeanne MM, Tan, Ban Hock, Low, Jenny GH
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197325/
https://www.ncbi.nlm.nih.gov/pubmed/25311929
http://dx.doi.org/10.1186/s12879-014-0547-7
_version_ 1782339605440233472
author Kalimuddin, Shirin
Tan, Jeanne MM
Tan, Ban Hock
Low, Jenny GH
author_facet Kalimuddin, Shirin
Tan, Jeanne MM
Tan, Ban Hock
Low, Jenny GH
author_sort Kalimuddin, Shirin
collection PubMed
description BACKGROUND: Effective protocols for the isolation and de-isolation of patients with suspected pulmonary tuberculosis (PTB) are essential determinants of health-care costs. Early de-isolation needs to be balanced with the need to prevent nosocomial transmission of PTB. The aim of our study was to evaluate the efficiency of our hospital’s current protocol for isolating and de-isolating patients with suspected PTB, in particular assessing the timeliness to de-isolation of patients with AFB smear negative respiratory samples. METHODS: We retrospectively reviewed 121 patients with suspected PTB who were admitted to our hospital’s isolation ward. We analyzed the time spent in isolation, the total number of respiratory samples that were collected for each patient and the time taken from collection of the first respiratory sample to release of the result of third respiratory sample for acid-fast bacilli (AFB) smear. We also calculated the direct cost of isolation for each patient. RESULTS: The mean and median number of AFB smears for each patient was three. Thirty percent of patients had four or more AFB smears taken and 20% were de-isolated before the results of three negative AFB smears were obtained. The mean duration of isolation was significantly shorter in patients who had fewer than three negative AFB smears compared to those who had three or more negative AFB smears (three days vs. five days, p <0.01). The mean cost in patients who were de-isolated before three negative smears were obtained was USD 947 compared to USD 1,636 in those were only de-isolated after three negative AFB smears (p <0.01). CONCLUSIONS: Our study suggests that our institution’s current infection control policy for the isolation of patients with suspected PTB is fairly satisfactory, but may need to be tightened further to prevent true cases of PTB being de-isolated prematurely. However, there may be instances when patients could potentially be de-isolated more quickly without risk to others, thus saving on the use of limited resources and costs to patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-014-0547-7) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4197325
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-41973252014-10-16 A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis Kalimuddin, Shirin Tan, Jeanne MM Tan, Ban Hock Low, Jenny GH BMC Infect Dis Research Article BACKGROUND: Effective protocols for the isolation and de-isolation of patients with suspected pulmonary tuberculosis (PTB) are essential determinants of health-care costs. Early de-isolation needs to be balanced with the need to prevent nosocomial transmission of PTB. The aim of our study was to evaluate the efficiency of our hospital’s current protocol for isolating and de-isolating patients with suspected PTB, in particular assessing the timeliness to de-isolation of patients with AFB smear negative respiratory samples. METHODS: We retrospectively reviewed 121 patients with suspected PTB who were admitted to our hospital’s isolation ward. We analyzed the time spent in isolation, the total number of respiratory samples that were collected for each patient and the time taken from collection of the first respiratory sample to release of the result of third respiratory sample for acid-fast bacilli (AFB) smear. We also calculated the direct cost of isolation for each patient. RESULTS: The mean and median number of AFB smears for each patient was three. Thirty percent of patients had four or more AFB smears taken and 20% were de-isolated before the results of three negative AFB smears were obtained. The mean duration of isolation was significantly shorter in patients who had fewer than three negative AFB smears compared to those who had three or more negative AFB smears (three days vs. five days, p <0.01). The mean cost in patients who were de-isolated before three negative smears were obtained was USD 947 compared to USD 1,636 in those were only de-isolated after three negative AFB smears (p <0.01). CONCLUSIONS: Our study suggests that our institution’s current infection control policy for the isolation of patients with suspected PTB is fairly satisfactory, but may need to be tightened further to prevent true cases of PTB being de-isolated prematurely. However, there may be instances when patients could potentially be de-isolated more quickly without risk to others, thus saving on the use of limited resources and costs to patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-014-0547-7) contains supplementary material, which is available to authorized users. BioMed Central 2014-10-14 /pmc/articles/PMC4197325/ /pubmed/25311929 http://dx.doi.org/10.1186/s12879-014-0547-7 Text en © Kalimuddin et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research Article
Kalimuddin, Shirin
Tan, Jeanne MM
Tan, Ban Hock
Low, Jenny GH
A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis
title A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis
title_full A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis
title_fullStr A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis
title_full_unstemmed A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis
title_short A retrospective review of a tertiary Hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis
title_sort retrospective review of a tertiary hospital’s isolation and de-isolation policy for suspected pulmonary tuberculosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197325/
https://www.ncbi.nlm.nih.gov/pubmed/25311929
http://dx.doi.org/10.1186/s12879-014-0547-7
work_keys_str_mv AT kalimuddinshirin aretrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis
AT tanjeannemm aretrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis
AT tanbanhock aretrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis
AT lowjennygh aretrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis
AT kalimuddinshirin retrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis
AT tanjeannemm retrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis
AT tanbanhock retrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis
AT lowjennygh retrospectivereviewofatertiaryhospitalsisolationanddeisolationpolicyforsuspectedpulmonarytuberculosis