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Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards

BACKGROUND/PURPOSE: Delayed diagnosis and isolation increases the risk of nosocomial transmission of tuberculosis (TB). To assess the risk of delayed management of TB, we analyzed the risk factors of prolonged delay in isolation of smear-positive TB patients in pulmonology/infectious diseases and ot...

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Autores principales: Hsieh, Meng-Jer, Liang, Huey-Wen, Chiang, Ping-Chern, Hsiung, Te-Chih, Huang, Chung-Chi, Chen, Ning-Hung, Hu, Han-Chung, Tsai, Ying-Huang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Formosan Medical Association & Elsevier. Published by Elsevier (Singapore) Pte Ltd 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135255/
https://www.ncbi.nlm.nih.gov/pubmed/19293035
http://dx.doi.org/10.1016/S0929-6646(09)60053-X
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author Hsieh, Meng-Jer
Liang, Huey-Wen
Chiang, Ping-Chern
Hsiung, Te-Chih
Huang, Chung-Chi
Chen, Ning-Hung
Hu, Han-Chung
Tsai, Ying-Huang
author_facet Hsieh, Meng-Jer
Liang, Huey-Wen
Chiang, Ping-Chern
Hsiung, Te-Chih
Huang, Chung-Chi
Chen, Ning-Hung
Hu, Han-Chung
Tsai, Ying-Huang
author_sort Hsieh, Meng-Jer
collection PubMed
description BACKGROUND/PURPOSE: Delayed diagnosis and isolation increases the risk of nosocomial transmission of tuberculosis (TB). To assess the risk of delayed management of TB, we analyzed the risk factors of prolonged delay in isolation of smear-positive TB patients in pulmonology/infectious diseases and other wards in a tertiary teaching hospital. METHODS: We enrolled smear-positive TB patients aged > 16 years with delayed respiratory isolation following hospitalization. Medical records were reviewed retrospectively. Time intervals between admission, order of sputum acid-fast staining, initiation of anti-tuberculous treatment and isolation were compared between pulmonology/infectious diseases wards (PIWs) and other wards. Risk factors were analyzed in patients with prolonged isolation delay of > 7 days in individual groups. RESULTS: Isolation was delayed in 191 (73.7%) of 259 hospitalized smear-positive TB patients. Median suspicion, treatment and isolation delays were 0, 3 and 4 days in PIWs and 1, 5 and 7 days in other wards. For patients admitted to non-PIWs, atypical chest radiographs, symptoms without dyspnea or not being admitted from the emergency department (ED) were risk factors for prolonged isolation delay exceeding 7 days. The only risk factor for delayed isolation in patients admitted to PIWs was age ≥ 70 years. CONCLUSION: Delays in suspicion, treatment and isolation of TB patients were longer in non-PIWs. Clinicians should be alert to those admitted to non-PIWs with atypical chest radiographs, atypical symptoms, or not admitted from the ED.
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spelling pubmed-71352552020-04-08 Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards Hsieh, Meng-Jer Liang, Huey-Wen Chiang, Ping-Chern Hsiung, Te-Chih Huang, Chung-Chi Chen, Ning-Hung Hu, Han-Chung Tsai, Ying-Huang J Formos Med Assoc Article BACKGROUND/PURPOSE: Delayed diagnosis and isolation increases the risk of nosocomial transmission of tuberculosis (TB). To assess the risk of delayed management of TB, we analyzed the risk factors of prolonged delay in isolation of smear-positive TB patients in pulmonology/infectious diseases and other wards in a tertiary teaching hospital. METHODS: We enrolled smear-positive TB patients aged > 16 years with delayed respiratory isolation following hospitalization. Medical records were reviewed retrospectively. Time intervals between admission, order of sputum acid-fast staining, initiation of anti-tuberculous treatment and isolation were compared between pulmonology/infectious diseases wards (PIWs) and other wards. Risk factors were analyzed in patients with prolonged isolation delay of > 7 days in individual groups. RESULTS: Isolation was delayed in 191 (73.7%) of 259 hospitalized smear-positive TB patients. Median suspicion, treatment and isolation delays were 0, 3 and 4 days in PIWs and 1, 5 and 7 days in other wards. For patients admitted to non-PIWs, atypical chest radiographs, symptoms without dyspnea or not being admitted from the emergency department (ED) were risk factors for prolonged isolation delay exceeding 7 days. The only risk factor for delayed isolation in patients admitted to PIWs was age ≥ 70 years. CONCLUSION: Delays in suspicion, treatment and isolation of TB patients were longer in non-PIWs. Clinicians should be alert to those admitted to non-PIWs with atypical chest radiographs, atypical symptoms, or not admitted from the ED. Formosan Medical Association & Elsevier. Published by Elsevier (Singapore) Pte Ltd 2009-03 2009-05-15 /pmc/articles/PMC7135255/ /pubmed/19293035 http://dx.doi.org/10.1016/S0929-6646(09)60053-X Text en Copyright © 2009 Formosan Medical Association & Elsevier. Published by Elsevier (Singapore) Pte Ltd. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Hsieh, Meng-Jer
Liang, Huey-Wen
Chiang, Ping-Chern
Hsiung, Te-Chih
Huang, Chung-Chi
Chen, Ning-Hung
Hu, Han-Chung
Tsai, Ying-Huang
Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards
title Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards
title_full Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards
title_fullStr Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards
title_full_unstemmed Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards
title_short Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards
title_sort delayed suspicion, treatment and isolation of tuberculosis patients in pulmonology/infectious diseases and non-pulmonology/infectious diseases wards
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135255/
https://www.ncbi.nlm.nih.gov/pubmed/19293035
http://dx.doi.org/10.1016/S0929-6646(09)60053-X
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