Kawasaki Takeshi, Sasaki Yuka, Nishimura Hiroki, Fujikawa Ayako, Mizuno Satoko, Shimura Ryuhi, Yamagishi Fumio
Department of Thoracic Disease, National Hospital Organization Chiba-East National Hospital, Japan.
Kekkaku. 2010 Sep;85(9):691-5.
To observe the current situation of tuberculosis and its control measures in hemodialysis facilities in Chiba Prefecture, Japan.
Questionnaires on medical dialysis and tuberculosis were sent to hemodialysis facilities in Chiba Prefecture.
The questionnaires were answered by 55 of 127 facilities. Of the respondents, 46 (83.6%) were not aware of the recommendation of treatment for latent tuberculosis infections in Japanese patients. Moreover, 30 (54.5%) facilities did not examine patients for tuberculosis prior to the initiation of hemodialysis. Of the 21 facilities that did assess patients for tuberculosis infection, only 5 (23.8%) performed a tuberculin skin test or QuantiFERON TB-2G. Three of the five (60.0%) that were treating tuberculosis by themselves expressed fear or uncertainty about the diagnosis and treatment of latent tuberculosis infections. During January 2006 through December 2007, tuberculosis patients were detected in 11 facilities, and the proportion of extrapulmonary tuberculosis among these patients was 52.4%. Seven facilities reported that they took no control measures against tuberculosis.
It is important to inform medical dialysis facilities about latent tuberculosis infections, the early diagnosis of tuberculosis, and the combination of nosocomial infection control. It is also important for experts in hemodialysis and tuberculosis to work closely together.
观察日本千叶县血液透析机构中结核病的现状及其控制措施。
向千叶县的血液透析机构发送关于医疗透析和结核病的调查问卷。
127家机构中有55家回复了问卷。在受访者中，46家（83.6%）不知道针对日本患者潜伏性结核感染的治疗建议。此外，30家（54.5%）机构在开始血液透析前未对患者进行结核病检查。在21家对患者进行结核病感染评估的机构中，只有5家（23.8%）进行了结核菌素皮肤试验或QuantiFERON TB-2G检测。自行治疗结核病的5家机构中有3家（60.0%）对潜伏性结核感染的诊断和治疗表示担忧或不确定。在2006年1月至2007年12月期间，11家机构检测到结核病患者，这些患者中肺外结核的比例为52.4%。7家机构报告称他们未采取针对结核病的控制措施。
向血液透析机构宣传潜伏性结核感染、结核病的早期诊断以及医院感染控制的结合非常重要。血液透析和结核病专家密切合作也很重要。
