The potential to transmit Mycobacterium tuberculosis at a South African tertiary teaching hospital.

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dc.contributor.authorSissolak D.
dc.contributor.authorBamford C.M.
dc.contributor.authorMehtar S.
dc.date.accessioned2011-05-15T16:16:44Z
dc.date.available2011-05-15T16:16:44Z
dc.date.issued2010
dc.description.abstractOBJECTIVES: To assess the risk of nosocomial transmission by confirmed pulmonary tuberculosis (PTB) patients in a high TB/HIV incidence environment. METHODS: Between November 2006 and April 2007, we carried out a cross-sectional survey of PTB patients with positive smears or cultures at an academic tertiary hospital in the Western Cape, South Africa. RESULTS: Of 394 confirmed PTB patients, only 199 (50.5%) had a known HIV status, of whom 107 (53.8%) were HIV-co-infected. Sensitivity testing for Mycobacterium tuberculosis (TB) was done in 49.3% of patients with available cultures (140/284). Of these patients, 9.3% (13/140) had multidrug-resistant (MDR) TB strains. The turnaround times (TAT) for culture and susceptibility testing were delayed: mean TAT for cultures was 27 days (range 63 days) and for susceptibility testing was 42 days (range 63 days). One fifth of PTB patients (82/394) were diagnosed from wards that do not deal with TB on a daily basis. PTB inpatients were hospitalized for an average of 13 days and were on average transferred twice. Only 14.2% of all PTB patients were notified to the South Africa Provincial Department of Health. Throughout their hospitalization, PTB patients were potentially infectious. CONCLUSIONS: The potential for nosocomial TB transmission in a setting of high TB and HIV co-infection with a high MDR prevalence, inconsistent infection prevention and control measures, and delayed diagnosis cannot be ignored. Barriers to TB infection control must urgently be addressed. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
dc.description.versionArticle
dc.identifier.citationInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
dc.identifier.citation14
dc.identifier.citation5
dc.identifier.issn18783511
dc.identifier.urihttp://hdl.handle.net/10019.1/13911
dc.subjectadolescent
dc.subjectadult
dc.subjectarticle
dc.subjectchild
dc.subjectcohort analysis
dc.subjectcross-sectional study
dc.subjectdisease transmission
dc.subjectfemale
dc.subjectgrowth, development and aging
dc.subjecthuman
dc.subjectinfant
dc.subjectisolation and purification
dc.subjectlung tuberculosis
dc.subjectmale
dc.subjectmicrobiology
dc.subjectmiddle aged
dc.subjectmultidrug resistant tuberculosis
dc.subjectMycobacterium tuberculosis
dc.subjectpreschool child
dc.subjectSouth Africa
dc.subjectstatistical model
dc.subjectAdolescent
dc.subjectAdult
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectCohort Studies
dc.subjectCross-Sectional Studies
dc.subjectDisease Transmission, Infectious
dc.subjectFemale
dc.subjectHumans
dc.subjectInfant
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMycobacterium tuberculosis
dc.subjectSouth Africa
dc.subjectTuberculosis, Multidrug-Resistant
dc.subjectTuberculosis, Pulmonary
dc.subjectYoung Adult
dc.titleThe potential to transmit Mycobacterium tuberculosis at a South African tertiary teaching hospital.
dc.typeArticle
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