TY - JOUR
T1 - Nosocomial transmission of tuberculosis in two hospitals for mentally handicapped patients
AU - Huang, Han Yu
AU - Jou, Ruwen
AU - Chiang, Chen Yuan
AU - Liu, Wen Chien
AU - Chiu, Hsien Jane
AU - Lee, Jen Jyh
N1 - Funding Information:
This study was financially supported by scientific research expense funding from the Centers for Disease Control, Department of Health, Taipei, Taiwan.
PY - 2007/12
Y1 - 2007/12
N2 - Background/Purpose: An unexpected significant increase in the number of tuberculosis (TB) cases in one hospital for mentally handicapped patients in eastern Taiwan was observed in early 2002. An active screening program was performed to identify undetected TB cases and to investigate nosocomial transmission of TB in two hospitals for mentally handicapped patients in eastern Taiwan. Methods: Active chest X-ray (CXR) screening followed by passive symptom screening were used to identify patients with pulmonary TB over 2 years in hospital A and B. IS6110 restriction fragment length polymorphism and spacer oligonucleotide typing (spoligotyping) profiles of the isolates, clinical record of each case, TB control policies of the two hospitals, and risk factors of nosocomial transmission were analyzed. Results: A total of 94.8% (2298/2423) inmates in hospital A and 96.3% (1902/1975) inmates in hospital B were screened by CXR at the beginning of 2002. During the 2-year study period, TB was diagnosed by sputum cultures for 30 patients in hospital A (notified disease rate = 619 per 100,000 population per year) and eight patients in hospital B (notified disease rate = 203 per 100,000 population per year). Seventeen patients (56.7%) in hospital A had six cluster pattern strains, and none did in hospital B, which high-lighted the importance of immediate expert consultation and thorough isolation of TB suspects. Conclusion: This is the first study to prove that thorough isolation by referring patients to general hospital as soon as possible could decrease nosocomial transmission of TB in hospitals for mentally handicapped patients. Routine CXR screening at admission and maintaining a high alert for TB in daily practice are essential.
AB - Background/Purpose: An unexpected significant increase in the number of tuberculosis (TB) cases in one hospital for mentally handicapped patients in eastern Taiwan was observed in early 2002. An active screening program was performed to identify undetected TB cases and to investigate nosocomial transmission of TB in two hospitals for mentally handicapped patients in eastern Taiwan. Methods: Active chest X-ray (CXR) screening followed by passive symptom screening were used to identify patients with pulmonary TB over 2 years in hospital A and B. IS6110 restriction fragment length polymorphism and spacer oligonucleotide typing (spoligotyping) profiles of the isolates, clinical record of each case, TB control policies of the two hospitals, and risk factors of nosocomial transmission were analyzed. Results: A total of 94.8% (2298/2423) inmates in hospital A and 96.3% (1902/1975) inmates in hospital B were screened by CXR at the beginning of 2002. During the 2-year study period, TB was diagnosed by sputum cultures for 30 patients in hospital A (notified disease rate = 619 per 100,000 population per year) and eight patients in hospital B (notified disease rate = 203 per 100,000 population per year). Seventeen patients (56.7%) in hospital A had six cluster pattern strains, and none did in hospital B, which high-lighted the importance of immediate expert consultation and thorough isolation of TB suspects. Conclusion: This is the first study to prove that thorough isolation by referring patients to general hospital as soon as possible could decrease nosocomial transmission of TB in hospitals for mentally handicapped patients. Routine CXR screening at admission and maintaining a high alert for TB in daily practice are essential.
KW - Mentally handicapped hospitals
KW - Nosocomial transmission
KW - Tuberculosis
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U2 - 10.1016/S0929-6646(08)60075-3
DO - 10.1016/S0929-6646(08)60075-3
M3 - Article
C2 - 18194905
AN - SCOPUS:38049110719
SN - 0929-6646
VL - 106
SP - 999
EP - 1006
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 12
ER -