Potential for nosocomial transmission of multidrug-resistant (MDR) tuberculosis in a South African tertiary hospital
Bamford, Colleen M.
Taljaard, Jantje J.
MetadataShow full item record
Background. Tuberculosis (TB) is a major health problem in the Western Cape, with an incidence exceeding 900 per 100 000 people. Nosocomial transmission of TB, and particularly drug-resistant TB, is a potential risk that may be undetected. Rapid diagnosis and rapid institution of effective anti-TB treatment, combined with appropriate infection control measures, are essential to prevent nosocomial transmission of TB. To estimate the potential for nosocomial transmission, we aimed to determine the in-hospital delays in diagnosis and treatment of patients with multidrug-resistant (MDR)-TB at a tertiary care hospital. Methods. A descriptive study, based on retrospective review of patient records and laboratory data, including all adult patients (>13 years) where TB culture and susceptibility testing confirmed MDR-TB on specimens submitted to Tygerberg Hospital's National Health Laboratory Service (NHLS) laboratory in 2007. Results. Thirty-one patients with MDR-TB were identified. The median laboratory turnaround time (TAT) from collection of specimen to confirmation of MDR-TB was 40 days, while the median time from the time of first presentation at Tygerberg Hospital to institution of MDR treatment was 44 days. Twenty patients were considered infectious during their hospital stay, generating 345 inpatient infectious days. Conclusions. The study suggests that there is an ongoing substantial risk for nosocomial transmission of MDR-TB at Tygerberg Hospital. We propose improvements, including the use of rapid drug susceptibility testing. The consistent application of infection control measures to prevent nosocomial spread of TB, including MDR-TB, remains vital.
Please cite this item using this persistent URLhttp://hdl.handle.net/10019.1/7780
Showing items related by title, author, creator and subject.
Efficacy of tigecycline versus ceftriaxone plus metronidazole for the treatment of complicated intra-abdominal infections: Results from a randomized, controlled trial Qvist N.; Warren B.; Leister-Tebbe H.; Zito E.T.; Pedersen R.; McGovern P.C.; Babinchak T. (2012)Background: This randomized, open-label, multi-center trial compared tigecycline (TGC), a broad-spectrum glycylcycline, with ceftriaxone- metronidazole (CTX/MET) for the treatment of complicated intra-abdominal infections ...
Cotton M.F. (2005)HIV infection is a multisystem disease characterised by progressive immunodeficiency and increasing susceptibility to common and opportunistic pathogens. Progressive disease is characterised by reversible and then permanent ...
Harries, A. D.; Zachariah, R.; Corbett, E. L.; Lawn, S. D.; Santos-Filho, E. T.; Chimzizi, R.; Harrington, M.; Maher, D.; Williams, B. G.; De Cock, K. M. (2010)Despite policies, strategies, and guidelines, the epidemic of HIV-associated tuberculosis continues to rage, particularly in southern Africa. We focus our attention on the regions with the greatest burden of disease, ...