title: Sputum smear-positive pulmonary tuberculosis: Is sputum smear examination required to discontinue airborne precautions?
abstract: OBJECTIVE
  Our aim was to evaluate the criteria required to discontinue airborne precautions for patients presenting with sputum smear-positive pulmonary tuberculosis as the need for sputum smear examinations is still a matter of debate.
  
  
  METHODS
  We conducted a retrospective study in the University Hospitals of Strasbourg (France) from July 2011 to July 2013. Our aim was to describe the results of sputum smear examinations and cultures obtained from treated patients presenting with drug-sensitive pulmonary tuberculosis. We included 97 patients in the study.
  
  
  CONCLUSIONS
  Nearly half of patients for whom a sputum smear examination was performed had a negative sputum direct examination but a positive culture. According to the literature, those patients are still likely to be contagious. This questions the safety of discontinuing airborne precautions in this situation. We also observed a great disparity in physicians' behaviors. Only half of them waited to get a negative sputum direct examination before discontinuing airborne precautions.
authors.affiliation: Maladies infectieuses et tropicales, nouvel hôpital civil, 67000 Strasbourg, France. Electronic address: xavier_argemi@hotmail.com.
authors.forename: X
authors.initials: X
authors.lastname: Argemi
authors.affiliation: Laboratoire de microbiologie, nouvel hôpital civil, 67000 Strasbourg, France.
authors.forename: M
authors.initials: M
authors.lastname: Albrecht
authors.affiliation: Maladies infectieuses et tropicales, nouvel hôpital civil, 67000 Strasbourg, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Hansmann
authors.affiliation: Laboratoire de microbiologie, nouvel hôpital civil, 67000 Strasbourg, France.
authors.forename: B
authors.initials: B
authors.lastname: Jaulhac
authors.affiliation: Laboratoire de microbiologie, nouvel hôpital civil, 67000 Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Koebel
authors.affiliation: Laboratoire de microbiologie, nouvel hôpital civil, 67000 Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Schramm
mesh_terms: D000328:Adult; D000336:Aerosols / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012449:Safety; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D016635:Universal Precautions; D019564:Unnecessary Procedures; D055815:Young Adult
chemical_list: D000336:Aerosols; D000995:Antitubercular Agents
keywords: Airborne precautions; Contrôle des expectorations; Isolement respiratoire; Sputum smear examination; Tuberculose; Tuberculosis