title: Tuberculosis screening in a dialysis unit: detecting latent tuberculosis infection is only half the problem.
abstract: Patients with chronic kidney disease are at increased risk of tuberculosis. We describe the events that occurred when we encountered a patient receiving haemodialysis with pulmonary tuberculosis. Nine (of 41) patients dialysing at the same time as the index case had a positive interferon-gamma release assay (IGRA) and were offered therapy for latent tuberculosis infection (LTBI). Patients with an initial negative IGRA were rescreened at six months, identifying a further three IGRA-positive patients. All patients were then rescreened at 12 months. No new IGRA-positive cases were identified and no staff or patients developed active disease. Only five of the 12 IGRA-positive patients completed LTBI therapy.
authors.affiliation: Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.
authors.forename: S O
authors.initials: SO
authors.lastname: Brij
authors.affiliation: Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.
authors.forename: S C
authors.initials: SC
authors.lastname: Beck
authors.affiliation: Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.
authors.forename: F
authors.initials: F
authors.lastname: Kleemann
authors.affiliation: Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.
authors.forename: A L
authors.initials: AL
authors.lastname: Jack
authors.affiliation: Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.
authors.forename: C
authors.initials: C
authors.lastname: Wilkinson
authors.affiliation: Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK. Electronic address: David.enoch@addenbrookes.nhs.uk.
authors.forename: D A
authors.initials: DA
authors.lastname: Enoch
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D016903:Drug Monitoring / Q000379:methods; D006436:Hemodialysis Units, Hospital; D006801:Humans; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000995:Antitubercular Agents
keywords: Dialysis; Interferon-gamma release assay; Tuberculosis