564. Pediatric Tuberculosis Consultations Across 5 CDC Regional Tuberculosis (TB) Training and Medical Consultation Centers (RTMCCs)
Session: Poster Abstract Session: Clinical Tuberculosis: Trends and Experiences
Thursday, October 8, 2015
Room: Poster Hall
Background:

The US Centers for Disease Control and Prevention (CDC) funds 5 Regional Tuberculosis (TB) Training and Medical Consultation Centers (RTMCCs) throughout the nation that provide training and consultation for TB control and management.  RTMCC utilization for assistance with diagnosis and management of TB in children has not been studied. We analyzed pediatric TB consultations performed across all RTMCCs in terms of frequency, question type, provider type, and setting.

Methods:

The CDC medical consultation database was queried for consultations for patients <18 years provided between 1/1/13-4/22/15 by RTMCCs (Curry International TB Center, Heartland National TB Center, Mayo Clinic Center for TB, New Jersey Medical School Global TB Institute, Southeastern National TB Center). Each query was categorized into 1 or more subject areas.

Results:

The 5 RTMCCs received 1197 consultation requests on 1154 unique children, representing 20% of all unique patients reviewed by the centers during the study period.  Providers requesting consults were primarily physicians (47%) or nurses (44%).  The majority of pediatric consult requests were from state and local public health departments (684, 57%), followed by hospital providers (204, 17%); fewer requests came from clinicians in private practice (87, 7%) or academic institutions (43, 4%). Consults addressed 14 different topics, most commonly management of children with TB disease (20%), latent TB infection (17%), diagnosis or laboratory testing (13%), and pharmacology (10%).

Conclusion:

Children comprised 20% of all patients reviewed by RTMCCs during the study period.  RTMCCs were utilized primarily by public health departments regarding management of TB disease, latent TB infection, and diagnosis or laboratory testing. The relative underutilization of the RTMCCs by clinicians in other settings, who often manage children with TB exposure or latent infection, warrants further study. As US TB case rates decline and providers become less experienced with childhood TB, RTMCC support may become increasingly important.  

Ritu Banerjee, MD, PhD, Division of Pediatric Infectious Diseases, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, Stephen Ryan, BS, Southeastern National TB Center, Gainesville, FL, Gregory Mader, MA, Mayo Clinic TB Center, Rochester, MN, Ana Alvarez, MD, Pediatric Infectious Diseases and Immunology,, University of Florida, Jacksonville, FL, Lisa Armitige, MD, PhD, Heartland National Tuberculosis Center, San Antonio, TX, Lisa Chen, MD, Curry International Tuberculosis Center/ University of California San Francisco, Oakland, CA, George D. Mcsherry, MD, Pennsylvania State University College of Medicine, Hershey, PA, John Wilson, MD, FIDSA, Infectious Disease, Mayo Clinic, Rochester, MN and Sundari Mase, MD, MPH, Dtbe/Fseb, Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

R. Banerjee, None

S. Ryan, None

G. Mader, None

A. Alvarez, None

L. Armitige, None

L. Chen, None

G. D. Mcsherry, None

J. Wilson, None

S. Mase, None

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