Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped Patients
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 tw...
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| Format: | Article |
| Language: | English |
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Elsevier
2007-12-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664608600753 |
| _version_ | 1811299068909977600 |
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| author | Han-Yu Huang Ruwen Jou Chen-Yuan Chiang Wen-Chien Liu Hsien-Jane Chiu Jen-Jyh Lee |
| author_facet | Han-Yu Huang Ruwen Jou Chen-Yuan Chiang Wen-Chien Liu Hsien-Jane Chiu Jen-Jyh Lee |
| author_sort | Han-Yu Huang |
| collection | DOAJ |
| description | 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 highlighted 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. |
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| format | Article |
| id | doaj.art-fc8c576e28e541eba559f25c97e3a022 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-13T06:29:42Z |
| publishDate | 2007-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-fc8c576e28e541eba559f25c97e3a0222022-12-22T02:58:15ZengElsevierJournal of the Formosan Medical Association0929-66462007-12-0110612999100610.1016/S0929-6646(08)60075-3Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped PatientsHan-Yu Huang0Ruwen Jou1Chen-Yuan Chiang2Wen-Chien Liu3Hsien-Jane Chiu4Jen-Jyh Lee5Division of Chest Medicine, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Department of Health, Taipei, TaiwanReference Laboratory of Mycobacteriology, Research and Diagnostic Center, Centers for Disease Control, Department of Health, Taipei, TaiwanInternational Union Against Tuberculosis and Lung Diseases, Paris, FranceYu-Li Veterans Hospital, Department of Health, Taipei, TaiwanYu-Li Hospital, Department of Health, Department of Health, Taipei, TaiwanDivision of Chest Medicine, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Department of Health, Taipei, TaiwanAn 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 highlighted 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.http://www.sciencedirect.com/science/article/pii/S0929664608600753mentally handicapped hospitalsnosocomial transmissiontuberculosis |
| spellingShingle | Han-Yu Huang Ruwen Jou Chen-Yuan Chiang Wen-Chien Liu Hsien-Jane Chiu Jen-Jyh Lee Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped Patients Journal of the Formosan Medical Association mentally handicapped hospitals nosocomial transmission tuberculosis |
| title | Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped Patients |
| title_full | Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped Patients |
| title_fullStr | Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped Patients |
| title_full_unstemmed | Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped Patients |
| title_short | Nosocomial Transmission of Tuberculosis in Two Hospitals for Mentally Handicapped Patients |
| title_sort | nosocomial transmission of tuberculosis in two hospitals for mentally handicapped patients |
| topic | mentally handicapped hospitals nosocomial transmission tuberculosis |
| url | http://www.sciencedirect.com/science/article/pii/S0929664608600753 |
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