772. Factors Associated with Healthcare Delay of Active Pulmonary Tuberculosis after Hospitalization
Session: Poster Abstract Session: Tuberculosis and Other Mycobacterial Infections
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • Factors Associated with Healthcare Delay of Active Pulmonary Tuberculosis after Hospitalization.pdf (271.8 kB)
  • Background: Hospitals are undesirable reservoirs for a respiratory outbreak. Active pulmonary tuberculosis (TB) can be readily transmitted among hospitalized patients. Early recognition of pulmonary TB is an essential priority against transmission. The aim of this study was to evaluate factors associated with delayed identification of pulmonary TB in hospital settings.

    Methods: Medical records of newly diagnosed TB patients admitted to a referral hospital from January 2015 through December 2017 were reviewed. Delayed recognition of pulmonary TB was defined as failure to initiate airborne isolation within the first 3 days after admission. We analyzed clinical, microbiological, radiological and healthcare factors associated with delayed recognition of pulmonary TB. Patients who were not suspected of having active pulmonary TB had no remarks about TB on their initial chest radiograph interpretation by radiologists. Multivariate logistic regression analysis was performed with significant factors included.

    Results: A total of 136 patients were analyzed who had positive sputum acid-fast bacilli (AFB) cultures. Of these, 45 (33%) patients were isolated 3 days after admission and had longer days of exposure before isolation (median 9, interquartile range [IQR] 6-14, p < 0.001) in comparison to others (median 0, IQR 0-1). Patients with older age (odds ratio [OR] = 1.04, 95% confidence interval [CI] 1.01-1.08, p = 0.01), patients who were admitted to departments other than infectious diseases or pulmonology (OR = 6.23, 95% CI 2.17-17.89, p = 0.001) and patients who were not suspected of having active pulmonary TB by radiologists (OR = 11.36, 95% CI 4.11-31.39, p < 0.001) were more likely to have delayed recognition of pulmonary TB.

    Conclusion: In a country with intermediate TB prevalence, better awareness for pulmonary TB is required for all hospitalized patients who are admitted to departments other than infectious diseases or pulmonology. Although active pulmonary TB is not suspected by a radiologist, sputum AFB smear and culture are necessary when new lesions are present in chest radiographs.

    Jaijun Han, MD1, Se Yoon Park, MD1, Jebyung Park, MD1, So Young Lee, BSN2, Gil Eun Kim, BSN2, Yeon Su Jeong, BSN2, Jin Hwa Kim, MSN2, Eunyoung Lee, MD1, Eun Jung Lee, MD1, Shi Nae Yu, MD3, Tark Kim, MD4, Min Hyok Jeon, MD3, Eun Ju Choo, MD4 and Tae Hyong Kim, MD, PhD1, (1)Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea, Republic of (South), (2)Infection Control Team, Soonchunhyang University Seoul Hospital, Seoul, Korea, Republic of (South), (3)Division of Infectious Diseases, Soonchunhyang University Cheonan Hospital, Cheonan, Korea, Republic of (South), (4)Division of Infectious Diseases, Soonchunhyang University Bucheon Hospital, Bucheon, Korea, Republic of (South)

    Disclosures:

    J. Han, None

    S. Y. Park, None

    J. Park, None

    S. Y. Lee, None

    G. E. Kim, None

    Y. S. Jeong, None

    J. H. Kim, None

    E. Lee, None

    E. J. Lee, None

    S. N. Yu, None

    T. Kim, None

    M. H. Jeon, None

    E. J. Choo, None

    T. H. Kim, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.