help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Bock, N. N.
Right arrow Articles by Blumberg, H. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bock, N. N.
Right arrow Articles by Blumberg, H. M.

Am. J. Respir. Crit. Care Med., Vol 154, No. 5, Nov 1996, 1468-1472.

Clinical predictors of tuberculosis as a guide for a respiratory isolation policy

NN Bock, JE McGowan Jr, J Ahn, J Tapia and HM Blumberg
Department of Medicine, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA.

An expanded respiratory isolation policy was implemented in a public hospital that cares for about 200 patients with active tuberculous each year. This led to proper isolation of > or = 95% of patients with tuberculosis on admission but involved an 8-fold overuse of isolation rooms. We developed a model policy to decrease overisolation of nontuberculous patients. Clinical findings in 295 patients admitted to respiratory isolation during a 3-mo period were evaluated for their usefulness in determining which patients had tuberculosis. Multivariate analysis identified five predictive variables: chest radiograph with upper lobe infiltrate (odds ratio, 5.00; CI, 2.38 to 10.51; p = 0.001) or cavity (odds ratio, 3.93; CI, 1.06 to 14.62; p = 0.041), history of having known someone with tuberculosis (odds ratio, 2.42; CI, 1.10 to 5.32, p = 0.027), self-reported positive tuberculin skin test (odds ratio, 5.67; CI, 1.57 to 22.01; p = 0.009), self-reported isoniazid preventive therapy (odds ratio, 0.18; CI, 0.04 to 0.82; p = 0.027). Using these variables to determine which patients required isolation would have decreased the number of isolated nontuberculous patients from 253 to 95, but it would have missed eight of 42 patients with tuberculosis. Further work is needed to identify clinical predictors that would decrease overuse of isolation beds while maintaining satisfactory sensitivity for patients with tuberculosis.


This article has been cited by other articles:


Home page
 CVIHome page
N. Khan, K. Alam, S. Nair, V. L. Valluri, K. J. R. Murthy, and S. Mukhopadhyay
Association of Strong Immune Responses to PPE Protein Rv1168c with Active Tuberculosis
Clin. Vaccine Immunol., June 1, 2008; 15(6): 974 - 980.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. K. Field and R. L. Cowie
Lung Disease Due to the More Common Nontuberculous Mycobacteria
Chest, June 1, 2006; 129(6): 1653 - 1672.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. Laifer, A. F. Widmer, R. Frei, W. Zimmerli, and U. Fluckiger
Polymerase Chain Reaction for Mycobacterium tuberculosis: Impact on Clinical Management of Refugees With Pulmonary Infiltrates
Chest, March 1, 2004; 125(3): 981 - 986.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. Long
Smear-Negative Pulmonary Tuberculosis in Industrialized Countries
Chest, August 1, 2001; 120(2): 330 - 334.
[Full Text] [PDF]

Home page
 ChestHome page
A. M. Kanaya, D. V. Glidden, and H. F. Chambers
Identifying Pulmonary Tuberculosis in Patients With Negative Sputum Smear Results
Chest, August 1, 2001; 120(2): 349 - 355.
[Abstract] [Full Text] [PDF]

Home page
 Arch Intern MedHome page
J. P. Wisnivesky, J. Kaplan, C. Henschke, T. G. McGinn, and R. G. Crystal
Evaluation of Clinical Parameters to Predict Mycobacterium tuberculosis in Inpatients
Arch Intern Med, September 11, 2000; 160(16): 2471 - 2476.
[Abstract] [Full Text]

Home page
 ChestHome page
T. K. Lim, A. Gough, N.-K. Chin, and G. Kumarasinghe
Relationship Between Estimated Pretest Probability and Accuracy of Automated Mycobacterium tuberculosis Assay in Smear-Negative Pulmonary Tuberculosis
Chest, September 1, 2000; 118(3): 641 - 647.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
A. Catanzaro, S. Perry, J. E. Clarridge, S. Dunbar, S. Goodnight-White, P. A. LoBue, C. Peter, G. E. Pfyffer, M. F. Sierra, R. Weber, et al.
The Role of Clinical Suspicion in Evaluating a New Diagnostic Test for Active Tuberculosis: Results of a Multicenter Prospective Trial
JAMA, February 2, 2000; 283(5): 639 - 645.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. Perez and W. Rodriguez
Screening of Tuberculosis : Is It a Real Prediction Model?
Chest, December 1, 1999; 116(6): 1841 - 1842.
[Full Text] [PDF]

Home page
 ChestHome page
P. Tattevin, E. Casalino, L. Fleury, G. Egmann, M. Ruel, and E. Bouvet
The Validity of Medical History, Classic Symptoms, and Chest Radiographs in Predicting Pulmonary Tuberculosis: Derivation of a Pulmonary Tuberculosis Prediction Model
Chest, May 1, 1999; 115(5): 1248 - 1253.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
V. K. Rao, E. P. Iademarco, V. J. Fraser, and M. H. Kollef
Delays in the Suspicion and Treatment of Tuberculosis among Hospitalized Patients
Ann Intern Med, March 2, 1999; 130(5): 404 - 411.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1996 American Thoracic Society