Risk factors for non-isolation of patients admitted for pulmonary tuberculosis in a high-incidence department: a single-centre retrospective study.

Autor: Oubbéa S; Infection Control Unit, Université Sorbonne Paris Nord, Centre Hospitalier Universitaire Avicenne, Assistance Publique - Hôpitaux de Paris, Bobigny, France., Pilmis B; Equipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France; Institut Micalis UMR 1319, Université Paris-Saclay, Institut National de Recherche Pour l'agriculture, l'alimentation et l'environnement, AgroParisTech, Jouy-en-Josas, France. Electronic address: bpilmis@ghpsj.fr., Seytre D; Infection Control Unit, Université Sorbonne Paris Nord, Centre Hospitalier Universitaire Avicenne, Assistance Publique - Hôpitaux de Paris, Bobigny, France., Lomont A; Infection Control Unit, Université Sorbonne Paris Nord, Centre Hospitalier Universitaire Avicenne, Assistance Publique - Hôpitaux de Paris, Bobigny, France., Billard-Pomares T; Département de Microbiologie Clinique, Centre Hospitalier Universitaire Avicenne, Assistance Publique - Hôpitaux de Paris, Bobigny, France., Zahar JR; Infection Control Unit, Université Sorbonne Paris Nord, Centre Hospitalier Universitaire Avicenne, Assistance Publique - Hôpitaux de Paris, Bobigny, France; Département de Microbiologie Clinique, Centre Hospitalier Universitaire Avicenne, Assistance Publique - Hôpitaux de Paris, Bobigny, France; IAME UMR 1137, INSERM, Université Paris-Cité, Paris, France., Foucault-Fruchard L; Pharmacy Department, Tours University Hospital, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
Jazyk: angličtina
Zdroj: The Journal of hospital infection [J Hosp Infect] 2024 Oct 10; Vol. 155, pp. 130-134. Date of Electronic Publication: 2024 Oct 10.
DOI: 10.1016/j.jhin.2024.09.020
Abstrakt: Background: Pulmonary tuberculosis (PTB) is an airborne disease, warranting the identification of suspected cases on admission, and their hospitalization in individual rooms with the implementation of airborne supplementary precautions (ASPs).
Aim: To identify the frequency of non-isolated PTB and the factors associated with the delay in implementing ASPs in a high-prevalence hospital.
Methods: This retrospective observational study included patients with at least one Mycobacterium tuberculosis-positive specimen. Patient demographic and clinical data, as well as data related to the mode of admission, were collected. Univariate and multi-variate statistical analyses were performed.
Findings: During the study period, 256 patients were included. Among them, 134 (52.3%) had PTB (75% males, median age 39 years, 70% foreign-born). Among these patients, 46 (34%) were isolated beyond 24 h of admission. The average time to implement ASPs was 4.3 days, and seven patients (5.2%) were not isolated throughout their hospital stay. Multi-variate analysis indicated that three factors were associated with isolation. Previous consultation with a general practitioner was associated with greater likelihood of isolation, whereas admission through the emergency department was not. The presence of so-called 'cardinal clinical signs' and a suggestive chest x-ray were also associated with greater likelihood of isolation. Finally, European patients were isolated less frequently than foreign-born patients.
Conclusion: In this study, 34% of patients admitted with PTB were not isolated on admission. The likelihood of non-isolation was three times higher in cases admitted via the emergency department, and European patients were isolated less frequently than foreign-born patients. The presence of cardinal signs and prior consultation with a general practitioner were associated with greater likelihood of isolation.
Competing Interests: Conflict of interest statement None declared.
(Copyright © 2024 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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