Mycobacterium tuberculosis nucleic acid amplification tests reduce nosocomial tuberculosis exposure in intensive care units: A nationwide cohort study

Jann Yuan Wang, Ming Chia Lee, Jer Hwa Chang, Ming Chih Yu, Vin Cent Wu, Kuo Liang Huang, Chiu Ping Su, Kun Mao Chao, Chih Hsin Lee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and objective This retrospective national surveillance study investigated the burden of and risk factors for nosocomial exposure of pulmonary tuberculosis (TB) in intensive care units. Methods Patients admitted to intensive care units were identified from the National Health Insurance Research Database. During 2004-2009, there were 1-387-707 intensive care unit admissions of 900-562 adult patients. Pulmonary tuberculosis association was considered if the patient was diagnosed with pulmonary tuberculosis during admission or within 3 months after discharge. Nosocomial transmissible period was calculated based on the length of anti-tuberculosis treatment and negative-pressure isolation during admission. Results Pulmonary tuberculosis was associated with 1.20% of all intensive care unit admissions and 6731 (38.9%) started anti-TB treatment during admission. For the other 10-583 admissions, the diagnosis was made after discharge and anti-TB treatment was not prescribed during admission. The probability paralleled the regional tuberculosis incidence. On average, 2794 pulmonary tuberculosis associated intensive care unit admissions contributed to 42-999-44-062 days of nosocomial exposure per year. The length of nosocomial transmissible period decreased with the gradual implementation of Mycobacterium tuberculosis nucleic acid amplification tests in intensive care practice. Multivariate linear regression analysis revealed that the length of nosocomial transmissible period was inversely associated with male gender, airway symptoms prior to admission and performing M. tuberculosis nucleic acid amplification tests and mycobacterial culture. Conclusions Nosocomial tuberculosis exposure is not uncommon in intensive care units. Performing rapid molecular diagnostic tests in those suspected of tuberculosis is recommended to reduce the risk of nosocomial exposure. Burden of nosocomial tuberculosis exposure in intensive care units was investigated. Pulmonary tuberculosis was associated with 1.20% of all intensive care unit admissions in Taiwan, contributing to 42-999-44-062 days of nosocomial exposure per year. The risk may be reduced by incorporating a rapid diagnostic tool in hospital infection control policy.

Original languageEnglish
Pages (from-to)1233-1240
Number of pages8
JournalRespirology
Volume20
Issue number8
DOIs
Publication statusPublished - Nov 1 2015

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Nucleic Acid Amplification Techniques
Mycobacterium tuberculosis
Intensive Care Units
Tuberculosis
Cohort Studies
Pulmonary Tuberculosis
Molecular Pathology
National Health Programs
Critical Care
Infection Control
Cross Infection
Taiwan
Routine Diagnostic Tests
Linear Models
Therapeutics
Regression Analysis
Databases

Keywords

  • aerosol therapy
  • cohort study
  • intensive care
  • nosocomial infection
  • pulmonary tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Mycobacterium tuberculosis nucleic acid amplification tests reduce nosocomial tuberculosis exposure in intensive care units : A nationwide cohort study. / Wang, Jann Yuan; Lee, Ming Chia; Chang, Jer Hwa; Yu, Ming Chih; Wu, Vin Cent; Huang, Kuo Liang; Su, Chiu Ping; Chao, Kun Mao; Lee, Chih Hsin.

In: Respirology, Vol. 20, No. 8, 01.11.2015, p. 1233-1240.

Research output: Contribution to journalArticle

Wang, Jann Yuan ; Lee, Ming Chia ; Chang, Jer Hwa ; Yu, Ming Chih ; Wu, Vin Cent ; Huang, Kuo Liang ; Su, Chiu Ping ; Chao, Kun Mao ; Lee, Chih Hsin. / Mycobacterium tuberculosis nucleic acid amplification tests reduce nosocomial tuberculosis exposure in intensive care units : A nationwide cohort study. In: Respirology. 2015 ; Vol. 20, No. 8. pp. 1233-1240.
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abstract = "Background and objective This retrospective national surveillance study investigated the burden of and risk factors for nosocomial exposure of pulmonary tuberculosis (TB) in intensive care units. Methods Patients admitted to intensive care units were identified from the National Health Insurance Research Database. During 2004-2009, there were 1-387-707 intensive care unit admissions of 900-562 adult patients. Pulmonary tuberculosis association was considered if the patient was diagnosed with pulmonary tuberculosis during admission or within 3 months after discharge. Nosocomial transmissible period was calculated based on the length of anti-tuberculosis treatment and negative-pressure isolation during admission. Results Pulmonary tuberculosis was associated with 1.20{\%} of all intensive care unit admissions and 6731 (38.9{\%}) started anti-TB treatment during admission. For the other 10-583 admissions, the diagnosis was made after discharge and anti-TB treatment was not prescribed during admission. The probability paralleled the regional tuberculosis incidence. On average, 2794 pulmonary tuberculosis associated intensive care unit admissions contributed to 42-999-44-062 days of nosocomial exposure per year. The length of nosocomial transmissible period decreased with the gradual implementation of Mycobacterium tuberculosis nucleic acid amplification tests in intensive care practice. Multivariate linear regression analysis revealed that the length of nosocomial transmissible period was inversely associated with male gender, airway symptoms prior to admission and performing M. tuberculosis nucleic acid amplification tests and mycobacterial culture. Conclusions Nosocomial tuberculosis exposure is not uncommon in intensive care units. Performing rapid molecular diagnostic tests in those suspected of tuberculosis is recommended to reduce the risk of nosocomial exposure. Burden of nosocomial tuberculosis exposure in intensive care units was investigated. Pulmonary tuberculosis was associated with 1.20{\%} of all intensive care unit admissions in Taiwan, contributing to 42-999-44-062 days of nosocomial exposure per year. The risk may be reduced by incorporating a rapid diagnostic tool in hospital infection control policy.",
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AU - Wang, Jann Yuan

AU - Lee, Ming Chia

AU - Chang, Jer Hwa

AU - Yu, Ming Chih

AU - Wu, Vin Cent

AU - Huang, Kuo Liang

AU - Su, Chiu Ping

AU - Chao, Kun Mao

AU - Lee, Chih Hsin

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N2 - Background and objective This retrospective national surveillance study investigated the burden of and risk factors for nosocomial exposure of pulmonary tuberculosis (TB) in intensive care units. Methods Patients admitted to intensive care units were identified from the National Health Insurance Research Database. During 2004-2009, there were 1-387-707 intensive care unit admissions of 900-562 adult patients. Pulmonary tuberculosis association was considered if the patient was diagnosed with pulmonary tuberculosis during admission or within 3 months after discharge. Nosocomial transmissible period was calculated based on the length of anti-tuberculosis treatment and negative-pressure isolation during admission. Results Pulmonary tuberculosis was associated with 1.20% of all intensive care unit admissions and 6731 (38.9%) started anti-TB treatment during admission. For the other 10-583 admissions, the diagnosis was made after discharge and anti-TB treatment was not prescribed during admission. The probability paralleled the regional tuberculosis incidence. On average, 2794 pulmonary tuberculosis associated intensive care unit admissions contributed to 42-999-44-062 days of nosocomial exposure per year. The length of nosocomial transmissible period decreased with the gradual implementation of Mycobacterium tuberculosis nucleic acid amplification tests in intensive care practice. Multivariate linear regression analysis revealed that the length of nosocomial transmissible period was inversely associated with male gender, airway symptoms prior to admission and performing M. tuberculosis nucleic acid amplification tests and mycobacterial culture. Conclusions Nosocomial tuberculosis exposure is not uncommon in intensive care units. Performing rapid molecular diagnostic tests in those suspected of tuberculosis is recommended to reduce the risk of nosocomial exposure. Burden of nosocomial tuberculosis exposure in intensive care units was investigated. Pulmonary tuberculosis was associated with 1.20% of all intensive care unit admissions in Taiwan, contributing to 42-999-44-062 days of nosocomial exposure per year. The risk may be reduced by incorporating a rapid diagnostic tool in hospital infection control policy.

AB - Background and objective This retrospective national surveillance study investigated the burden of and risk factors for nosocomial exposure of pulmonary tuberculosis (TB) in intensive care units. Methods Patients admitted to intensive care units were identified from the National Health Insurance Research Database. During 2004-2009, there were 1-387-707 intensive care unit admissions of 900-562 adult patients. Pulmonary tuberculosis association was considered if the patient was diagnosed with pulmonary tuberculosis during admission or within 3 months after discharge. Nosocomial transmissible period was calculated based on the length of anti-tuberculosis treatment and negative-pressure isolation during admission. Results Pulmonary tuberculosis was associated with 1.20% of all intensive care unit admissions and 6731 (38.9%) started anti-TB treatment during admission. For the other 10-583 admissions, the diagnosis was made after discharge and anti-TB treatment was not prescribed during admission. The probability paralleled the regional tuberculosis incidence. On average, 2794 pulmonary tuberculosis associated intensive care unit admissions contributed to 42-999-44-062 days of nosocomial exposure per year. The length of nosocomial transmissible period decreased with the gradual implementation of Mycobacterium tuberculosis nucleic acid amplification tests in intensive care practice. Multivariate linear regression analysis revealed that the length of nosocomial transmissible period was inversely associated with male gender, airway symptoms prior to admission and performing M. tuberculosis nucleic acid amplification tests and mycobacterial culture. Conclusions Nosocomial tuberculosis exposure is not uncommon in intensive care units. Performing rapid molecular diagnostic tests in those suspected of tuberculosis is recommended to reduce the risk of nosocomial exposure. Burden of nosocomial tuberculosis exposure in intensive care units was investigated. Pulmonary tuberculosis was associated with 1.20% of all intensive care unit admissions in Taiwan, contributing to 42-999-44-062 days of nosocomial exposure per year. The risk may be reduced by incorporating a rapid diagnostic tool in hospital infection control policy.

KW - aerosol therapy

KW - cohort study

KW - intensive care

KW - nosocomial infection

KW - pulmonary tuberculosis

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