Abstract
Tuberculosis Exposure and Conversion Rates Can Guide Deimplementation of Annual Tuberculosis Screening
Infection control and hospital epidemiology, Vol.41(S1), pp.s419-s419
10/2020
DOI: 10.1017/ice.2020.1075
Abstract
Background:
The CDC recently updated recommendations on tuberculosis (TB) screening in healthcare facilities, suggesting the discontinuation of annual TB screening. However, hospitals may opt to continue based on their local TB epidemiology. We assessed TB infection control parameters in our facility to guide the implementation of the new CDC recommendations.
Methods:
We retrieved data for patients with an
International Classification of Disease, Tenth Revision
(ICD-10) code for TB treated at the University of Iowa Hospitals and Clinics during 2016–2019. We supplemented our search with microbiology data: culture or PCR for
Mycobacterium tuberculosis
. Based on manual chart review, we adjudicated each patient as active TB, latent TB, previously treated TB, unclear history, or no TB. We further labeled active TB cases based on their risk of transmission (pulmonary or extrapulmonary cases that underwent an aerosol generating procedure). We then calculated the number of exposure events associated with those patients and tuberculin skin test (TST) conversion rates among the exposed.
Results:
During 2016–2019, we identified 197 patients based on ICD-10 codes. In total, 10 additional patients were detected by microbiology data review. Of these 207 patients, 48 (23.2%) had active TB: lung, n = 24 (50%); lymph node, n = 9 (19%); bone or spine, n = 5 (10%); eye, n = 3 (6%); disseminated, n = 2 (4%); pleura, n = 2 (4%); skin abscess, n = 2 (4%); and meningitis, n = 1 (2%). Of the 24 pulmonary patients, 6 (25%) had either a positive smear or a cavity on imaging. In total, 159 patients were excluded: no TB, n = 22 (14%); latent TB, n = 27 (17%); old or treated TB, n = 93 (58%); and unclear history, n = 9 (6%). Of the 48 cases with active TB, 31 (65%) were deemed potentially infectious. Also, 10 cases (32%) led to the exposure of 204 healthcare workers (HCWs). Baseline and postexposure TST were available for 179 HCWs (88%); 72 (35%) followed up in the employee health clinic within the 8–12 weeks after exposure. Of 161 HCWs with a negative TST at baseline, no conversions occurred. Of 18 HCWs with positive TST at baseline, no HCW developed symptoms during the observation period.
Conclusions:
Nearly one-third of infectious TB cases led to HCW exposures in a low-incidence setting. However, no TST conversions or active TB infections were seen. Exposure and conversion rates are useful indicators of TB infection control in healthcare facilities and may help guide implementation of the new CDC TB control recommendations.
Funding:
None
Disclosures:
None
Details
- Title: Subtitle
- Tuberculosis Exposure and Conversion Rates Can Guide Deimplementation of Annual Tuberculosis Screening
- Creators
- Holly MeachamTakaaki KobayashiMohammed AlsuhaibaniStephanie HolleyMichael EdmondDaniel DiekemaAngie DainsOluchi AbosiMary KuklaKyle JennJorge Salinas
- Resource Type
- Abstract
- Publication Details
- Infection control and hospital epidemiology, Vol.41(S1), pp.s419-s419
- DOI
- 10.1017/ice.2020.1075
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Language
- English
- Date published
- 10/2020
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9984362679602771
Metrics
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