Investigation of healthcare‐associated transmission of <i>Mycobacterium tuberculosis</i> among patients with malignancies at three hospitals and at a residential facility

Malone, Joseph L.; Ijaz, Kashef; Lambert, Lauren A.; Rosencrans, Louie; Phillips, Lorraine J.; Tomlinson, Victor; Arbise, Michael; Moolenaar, Ronald L.; Dworkin, Mark S.; Simões, Eduardo J.

doi:10.1002/cncr.20698

Cited by 24 publications

(12 citation statements)

References 30 publications

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“…The immune state at the time of exposure to an infectious agent, interaction between pathogens, and virulence factors intrinsic to the agent are important predictors of an individual's outcome. Host factors such as extremes of age and underlying disease (eg, diabetes 56,57 , human immunodeficiency virus/acquired immune deficiency syndrome [HIV/ AIDS], 58,59 malignancy, and transplantation 18,60,61 ) can increase susceptibility to infection, as can various medications that alter the normal flora (eg, antimicrobial agents, gastric acid suppressors, corticosteroids, antirejection drugs, antineoplastic agents, immunosuppressive drugs). Surgical procedures and radiation therapy impair defenses of the skin and other involved organ systems.…”

Section: Ib Rationale For Standard and Transmission-based Precautiomentioning

confidence: 99%

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings

Siegel¹,

Rhinehart²,

Jackson³

et al. 2007

American Journal of Infection Control

2,727

2,604

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Section: Ib Rationale For Standard and Transmission-based Precautiomentioning

confidence: 99%

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings

Siegel¹,

Rhinehart²,

Jackson³

et al. 2007

American Journal of Infection Control

2,727

2,604

View full text Add to dashboard Cite

“…The treatment costs for patients with TB range from $28 000 per patient [19] for a patient with drug-susceptible tuberculosis to $134 000 for MDR TB and $430 000 for XDR TB [20]. In addition, the cost of TB contact tracing is significant, including the time of frontline staff to compile the list of potentially exposed individuals, the infection preventionist time to coordinate the exposure evaluation and send notification letters to patients and HCP, the time and direct cost to screen HCP for LTBI with tuberculin skin testing or interferon gamma release assays, the costs in time of work lost for HCP and patients during LTBI testing, and the cost of therapy for LTBI infection among those found to be infected among others [21, 22]. …”

Section: Discussionmentioning

confidence: 99%

Tuberculosis Patients Who Are A Potential Source for Unprotected Exposure in Health Care Systems: A Multicenter Case Control Study

Cadena

Castro-Pena

Javeri

et al. 2017

Open Forum Infectious Diseases

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SettingFive health care systems in Texas.ObjectiveTo 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.DesignA 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.ResultsThere 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).ConclusionsTB 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.

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“…Furthermore, it is important to provide LTBI treatment for elderly contacts who have comorbidities regardless of LTBI test results. The above findings were due to lower sensitivity to TST in the elderly [ 32 – 36 ]. Testing by interferon-gamma release assay (IGRA) may be considered in the elderly.…”

Section: Discussionmentioning

confidence: 99%

A pulmonary tuberculosis outbreak in a long-term care facility

et al. 2015

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SUMMARYIn long-term care facilities (LTCFs), the elderly are apt to be infected because those with latent tuberculosis infections (LTBIs) are at an increased risk for reactivation and post-primary TB disease. We report an outbreak of TB in staff and residents in a LTCF. An outbreak investigation was conducted after two TB cases were reported from the LTCF. A tuberculin skin test (TST), bacteriological examination and chest radiograph were administered to all facility staff and residents. An outbreak is defined as at least two epidemiologically linked cases that have identical Mycobacterium tuberculosis genotype isolates. This outbreak infected eight residents and one staff member, who were confirmed to have TB in a LTCF between September 2011 and October 2012. Based on the Becker method, the latent and infectious periods were estimated at 223·6 and 55·9 days. Two initial TST-negative resident contacts were diagnosed as TB cases through comprehensive TB screening. Observing elderly people who have a negative TST after TB screening appears to be necessary, given the long latent period for controlling a TB outbreak in a LTCF. It is important to consider providing LTBI treatment for elderly contacts.

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Investigation of healthcare‐associated transmission of Mycobacterium tuberculosis among patients with malignancies at three hospitals and at a residential facility

Cited by 24 publications

References 30 publications

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings

Tuberculosis Patients Who Are A Potential Source for Unprotected Exposure in Health Care Systems: A Multicenter Case Control Study

A pulmonary tuberculosis outbreak in a long-term care facility

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