Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-19T08:44:24.210Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of a Coordinated Tuberculosis Team in an Inner-City Hospital in New York City

Published online by Cambridge University Press:  02 January 2015

Barkat A. Fazal ,
Edward E. Telzak ,
Steve Blum ,
Cathy L. Pollard ,
Mordechai Bar ,
Jerome A. Ernst  and
Glenn S. Turett
Barkat A. Fazal*
Affiliation:
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York
Edward E. Telzak
Affiliation:
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York
Steve Blum
Affiliation:
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York
Cathy L. Pollard
Affiliation:
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York
Mordechai Bar
Affiliation:
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York
Jerome A. Ernst
Affiliation:
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York
Glenn S. Turett
Affiliation:
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, New York
*
Division of Infectious Diseases, Bronx-Lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY10457
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To evaluate the impact of a coordinated approach for the isolation, diagnosis, and treatment of patients with tuberculosis.

Design:

Retrospective cohort study.

Setting:

Bronx-Lebanon Hospital Center, an inner-city hospital in the South Bronx, New York City.

Patients:

Patients with smear-positive, culture-confirmed pulmonary tuberculosis.

Interventions:

Institution of a coordinated tuberculosis team.

Results:

Admissions of 46 patients before and 39 patients after the formation of a tuberculosis team were reviewed. Before institution of the tuberculosis team, 35% of patients were isolated within 24 hours of presentation, 41% never were isolated, and the mean number of days patients were not isolated was 19. After implementation of the tuberculosis team, 59% of patients were isolated within 24 hours, only 5% were never isolated, and the mean number of days patients were not isolated was 3.5. These differences were statistically significant. There also was a corresponding decrease in length of hospitalization. In addition, there were noticeable improvements in patient and staff morale and attitudes.

Conclusions:

The tuberculosis team likely has decreased the risk of nosocomial tuberculosis transmission by increasing the proportion of infectious tuberculosis patients admitted into AFB isolation and by reducing (by 780) the number of days out of isolation while smear positive. There also were concomitant financial savings.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 6 , June 1995 , pp. 340 - 343
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Centers for Disease Control and Prevention. Expanded tuberculosis surveillance and tuberculosis morbidity-United States. MMWR 1994;43:361–366.Google Scholar
2.New York City Department of Health. Tuberculosis in New York City. New York City, NY: Bureau of Tuberculosis Control; 1993. NYC Department of Health information summary.Google Scholar
3.Turett, G, Telzak, E, Millet, W, Daya, N, Lorian, V. Changes in susceptibility of Mycobacterium tuberculosis at an inner-city hospital in New York City. Taken from IDSA Annual Meeting; October 1617.1993; New Orleans, LA. Abstract 251.Google Scholar
4.Bass, JB, Farer, LS, Hopewell, PC, Jacobs, RFSnider, DE. Diagnostic standards and classification of tuberculosis. Am Rev Respir Dis 1990;142:725–735.Google Scholar
5.Di Perri, G, Cruciani, M, Danzi, MC, et al.Nosocomial epidemic of active tuberculosis among HIV-infected patients. Lancet 1989;2:1502–1504.Google Scholar
6.Centers for Disease Control and Prevention. Nosocomial transmission of multi-drug resistant tuberculosis among HIV-infected persons-Florida and New York, 1988-1991. MMWR 1991;40:585–591.Google Scholar
7.Centers for Disease Control and Prevention. Nosocomial transmission of multi-drug resistant tuberculosis to healthcare workers and HIV-infected patients in an urban hospital-Florida. MMWR 1990;39:718–722.Google Scholar
8.Centers for Disease Control and Prevention. Outbreak of multi-drug resistant tuberculosis at a hospital-New York City, 1991. MMWR 1993;42:427–434.Google Scholar
9.Centers for Disease Control and Prevention. Transmission of multi-drug-resistant tuberculosis among immunocompromised persons in a correctional system-New York, 1991. MMWR 1992;41:507–509.Google Scholar
10.Centers for Disease Control and Prevention. Guidelines for preventing the transmission of tuberculosis in health-care settings, with special focus on HIV-related issues. MMWR 1990;39:1–29.Google Scholar