Changing patterns of mycobacterial disease at a teaching community hospital.
Infect Control Hosp Epidemiol
; 15(8): 513-5, 1994 Aug.
Article
em En
| MEDLINE
| ID: mdl-7983343
ABSTRACT
OBJECTIVES:
To evaluate trends in the occurrence and diagnosis of mycobacterial disease.DESIGN:
Prospective surveillance study using a central tuberculosis registry at a 611-bed teaching community hospital.RESULTS:
Data pertaining to 715 patients were entered into the registry between 1976 and 1991 on the basis of positive smears or cultures for acid-fast bacilli (AFB). Over time, the ratio of isolates of Mycobacterium tuberculosis to isolates of nontuberculous mycobacteria reversed (from 3.2 to 1 between 1976 and 1981 to 1 to 1.6 between 1986 and 1991). The sensitivity of the sputum AFB smear for diagnosis of pulmonary tuberculosis increased (from 0.73 to 0.96), but the positive predictive value of the sputum AFB smear declined (from 0.72 to 0.59). The acquired immunodeficiency syndrome epidemic accounted for these changes only to a small extent.CONCLUSIONS:
The increasing occurrence of non-tuberculous mycobacterial disease and the declining positive predictive value of the sputum AFB smear at this hospital imply that respiratory isolation and antituberculous therapy will be used inappropriately for many patients. The development and use of newer tests for early isolation and specific identification of M tuberculosis should be accelerated.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose Pulmonar
/
Hospitais Comunitários
/
Hospitais de Ensino
/
Infecções por Mycobacterium
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
1994
Tipo de documento:
Article