title: [Sputum smear-positive tuberculosis diagnosed after hospitalization].
abstract: A tuberculosis infection-control program is based on a 3-level hierarchy of measures, including administrative, environmental, and respiratory protection. The most important level of tuberculosis controls is the use of administrative measures to reduce the risk of exposure to patients who might have infectious tuberculosis. In 126 patients tuberculosis was given diagnosed in our hospital over 10 years, and 51 patients among them had bacilli-positive sputum smears, of whom 26 were given diagnoses after admission, and 15 patients of these, in whom tuberculosis was not strongly suspected on admission, were considered to be at risk of nosocomial infection. The mean age of these 15 patients was 66.3 years, and 9 of them were given diagnoses of pneumonia. Duration until tuberculosis diagnosis was within 3 days in 11 patients, 4 to 7 days in 2, and more than 8 days in 2 patients. Twelve patients were admitted from the emergency room or belonged to other departments than respiratory medicine. We believe that it is important to consider tuberculosis when deciding about admission, in order not to delay diagnosis. Furthermore, ventilation of general rooms must be sufficient when dealing with the unexpected admission of patients with tuberculosis, and ability of health-care workers to use N95 respirators should be confirmed.
authors.affiliation: Department of Respiratory Medicine, Tokyo Rosai Hospital.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tojima
authors.forename: Munehisa
authors.initials: M
authors.lastname: Fukusumi
authors.forename: Kenji
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibata
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Aizawa
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000517:prevention & control*; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D042241:Early Diagnosis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D013183:Sputum / Q000382:microbiology*; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*