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Hospital Management of Tuberculosis in a Region With a Low Incidence of Tuberculosis and a High Prevalence of Nontuberculous Mycobacteria

Published online by Cambridge University Press:  02 January 2015

Barbara D. Alexander ,
Jason E. Stout ,
L. Barth Reller  and
Carol Dukes Hamilton
Barbara D. Alexander*
Affiliation:
Departments of Medicine, Duke University Medical Center, Durham, North Carolina
Jason E. Stout
Affiliation:
Departments of Medicine, Duke University Medical Center, Durham, North Carolina
L. Barth Reller
Affiliation:
Pathology, Duke University Medical Center, Durham, North Carolina
Carol Dukes Hamilton
Affiliation:
Departments of Medicine, Duke University Medical Center, Durham, North Carolina
*
Box 3038, Department of Medicine, Duke University Medical Center, Durham, NC 27710
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Abstract

We prospectively assessed the management of patients with suspected tuberculosis (TB) in an area with a high prevalence of nontuberculous mycobacteria (NTM) and a low incidence of TB. Clinicians' assessments were sensitive for TB but had poor predictive value. The acid-fast smear was a weak predictor of TB, owing to a high rate of isolation of NTM.

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 11 , November 2001 , pp. 715 - 717
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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References

1.Centers for Disease Control and Prevention, Division of Tuberculosis Elimination. Surveillance Report: Reported Tuberculosis in the United States, 1999. Atlanta, GA: CDC; 2000. www.cdc.gov/nchstp/tb/surv/surv99/surv99old.htm. Last updated December 8, 2001.Google Scholar
2.Counsell, SR, Tan, JS, Dittus, RS. Unsuspected pulmonary tuberculosis in a community teaching hospital. Arch Intern Med 1989;149:1274–1278.Google Scholar
3.Raffalli, J, Sepkowitz, KA, Armstrong, D. Community-based outbreaks of tuberculosis. Arch Intern Med 1996;156:1053–1060.Google Scholar
4.Long, R, Scalcini, M, Manfreda, J, Jean-Baptiste, M, Hershfield, E. The impact of HIV on the usefulness of sputum smears for the diagnosis of tuberculosis. Am J Public Health 1991;8:1326–1328.CrossRefGoogle Scholar
5.Kramer, F, Modilevsky, T, Waliany, AR, Leedom, JM, Barnes, PF. Delayed diagnosis of tuberculosis in patients with human immunodeficiency virus infection. Am J Med 1990;89:451–456.Google Scholar
6.Singh, N, Paterson, DL. Mycobacterium tuberculosis infection in solid-organ transplant recipients: impact and implications for management. Clin Infect Dis 1998;27:1266–1277.Google Scholar
7.Yajko, DM, Nassos, PS, Sanders, CA, Madej, JJ, Hadley, WK. High predictive value of the acid-fast smear for Mycobacterium tuberculosis despite the high prevalence of Mycobacterium avium complex in respiratory specimens. Clin Infect Dis 1994;19:334–336.Google Scholar
8.Bock, NN, McGowan, JE Jr, Ahn, J, Tapia, J, Blumberg, HM. Clinical predictors of tuberculosis as a guide for a respiratory isolation policy. Am J Respir Crit Care Med 1996;154:1468–1472.Google Scholar
9.El Solh, A, Mylotte, J, Sherif, S, Serghani, J, Grant, BJ. Validity of a decision tree for predicting active pulmonary tuberculosis. Am J Respir Crit Care Med 1997;155:1711–1716.Google Scholar
10.Cohen, R, Muzaffar, S, Capellan, J, Azar, H, Chinikamwala, M. The validity of classic symptoms and chest radiographic configuration in predicting pulmonary tuberculosis. Chest 1996;109:420–423.Google Scholar
11.Scott, B, Schmid, M, Nettleman, MD. Early identification and isolation of inpatients at high risk for tuberculosis. Arch Intern Med 1994;154:326–330.Google Scholar