Tuberculosis Patients Who Are A Potential Source for Unprotected Exposure in Health Care Systems: A Multicenter Case Control Study
Autor: | Norys A Castro-Pena, Jean Przykucki, Pranavi Sreeramoju, Heta Javeri, Michele Adams, Gustavo Valero, Jason Bowling, Jose Cadena, Jan E. Patterson, James H. Jorgensen, Ana Fuentes Arzola, Chetan Jinadatha, Joel E. Michalek, Brian Hernandez, Miloni Shroff |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
safety
medicine.medical_specialty Tuberculosis 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology medicine Major Article Infection control 030212 general & internal medicine medicine.diagnostic_test business.industry Case-control study Retrospective cohort study Odds ratio medicine.disease infection control Surgery Infectious Diseases 030228 respiratory system Oncology exposure Sputum medicine.symptom business Chest radiograph pulmonary tuberculosis |
Zdroj: | Open Forum Infectious Diseases |
ISSN: | 2328-8957 |
Popis: | Setting Five health care systems in Texas. Objective To describe the epidemiology of inadequate isolation for pulmonary tuberculosis leading to tuberculosis (TB) exposures from confirmed TB patients and the patient factors that led to the exposures. Design A retrospective cohort and case-control study of adult patients with TB resulting in exposures (cases) vs those TB patients who did not result in exposures (controls) during January 2005 to December 2012. Results There were 335 patients with pulmonary TB disease, 199 cases and 136 controls. There was no difference between groups in age (46 ± 14.6 vs 45 ± 17 years; P > .05), race, or substance abuse. Cases were more likely to be transplant recipients (adjusted odds ratio [AOR], 18.90; 95% CI, 1.9–187.76), have typical TB chest radiograph (AOR, 2.23; 95% CI, 1.1–4.51), and have positive acid-fast bacilli stains (AOR, 2.36; 95% CI, 1.31–4.27). Cases were less likely to have extrapulmonary disease (AOR, 0.47; 95% CI, 0.24–0.95). Conclusions TB exposure resulting from inadequate isolation is frequent in health care settings. Extrapulmonary involvement resulted in earlier airborne isolation. Being a transplant recipient, having chest radiograph findings typical for TB, and sputum positivity acid-fast bacilli upon staining were associated with increased risk of inadequate isolation. |
Databáze: | OpenAIRE |
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