[Current status of patients discharging Mycobacterium tuberculosis after admission to Kawasaki Medical School Hospital].
OBJECTIVE
To investigate the current status of patients with tuberculosis in Kawasaki Medical School Hospital which has closed tuberculosis isolation ward and review the nosocomial tuberculosis infection control.


METHODS
Clinical analysis was performed and nosocomial tuberculosis infection control were examined in 39 patients from whom Mycobacterium tuberculosis was isolated in Kawasaki Medical School Hospital between January 2001 and August 2004.


RESULTS
Mycobacterium tuberculosis was isolated in 16 patients in the Respiratory Division of the Department of Internal Medicine and in 23 patients in non-respiratory divisions. Thirty-four patients had underlying diseases and of these 14 patients had malignant diseases. The final diagnosis was pulmonary tuberculosis in 23 patients, and pulmonary tuberculosis was suspected in 13 patients on admission. The remaining 10 patients were treated for pneumonia on admission. M. tuberculosis was isolated most frequently from the sputum in 21 patients and 13 of them were smear positive who needs nosocomial infection control measures. Health examinations of the families and hospital staff in contact with these 13 patients with smear positive sputum after the diagnosis of tuberculosis revealed no active case of tuberculosis.


CONCLUSIONS
This study has shown that there are many cases with an atypical pattern for pulmonary tuberculosis among patients with underlying diseases, especially malignant diseases. There are still many tuberculosis patients who were diagnosed pneumonia after the admission and were administered antibiotics. We believe that more educational guidance regarding tuberculosis is needed for the hospital staff.
Kobashi
Yoshihiro
Y
Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki-shi, Okayama 701-0192, Japan. resp@med.kawasaki-m.ac.jp
Fukuda
Minoru
M
Yoshida
Kouichiro
K
Miyashita
Naoyuki
N
Niki
Yoshihito
Y
Oka
Mikio
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016867:Immunocompromised Host; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009369:Neoplasms / Q000150:complications; D009894:Opportunistic Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control; D012189:Retrospective Studies; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology* / Q000517:prevention & control