Fazal B A, Telzak E E, Blum S, Pollard C L, Bar M, Ernst J A, Turett G S
Department of Medicine, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, NY 10457, USA.
Infect Control Hosp Epidemiol. 1995 Jun;16(6):340-3. doi: 10.1086/647122.
To evaluate the impact of a coordinated approach for the isolation, diagnosis, and treatment of patients with tuberculosis.
Retrospective cohort study.
Bronx-Lebanon Hospital Center, an inner-city hospital in the South Bronx, New York City.
Patients with smear-positive, culture-confirmed pulmonary tuberculosis.
Institution of a coordinated tuberculosis team.
Admissions of 46 patients before and 39 patients after the formation of a tuberculosis team were reviewed. Before institution of the tuberculosis team, 35% of patients were isolated within 24 hours of presentation, 41% never were isolated, and the mean number of days patients were not isolated was 19. After implementation of the tuberculosis team, 59% of patients were isolated within 24 hours, only 5% were never isolated, and the mean number of days patients were not isolated was 3.5. These differences were statistically significant. There also was a corresponding decrease in length of hospitalization. In addition, there were noticeable improvements in patient and staff morale and attitudes.
The tuberculosis team likely has decreased the risk of nosocomial tuberculosis transmission by increasing the proportion of infectious tuberculosis patients admitted into AFB isolation and by reducing (by 780) the number of days out of isolation while smear positive. There also were concomitant financial savings.
评估采用协调一致的方法对肺结核患者进行隔离、诊断和治疗的影响。
回顾性队列研究。
纽约市布朗克斯南部市中心医院布朗克斯-黎巴嫩医院中心。
痰涂片阳性、培养确诊的肺结核患者。
设立一个协调的结核病治疗小组。
对结核病治疗小组成立前的46例患者和成立后的39例患者的入院情况进行了回顾。在结核病治疗小组设立之前，35%的患者在就诊后24小时内被隔离，41%的患者从未被隔离，患者未被隔离的平均天数为19天。实施结核病治疗小组后，59%的患者在24小时内被隔离，只有5%的患者从未被隔离，患者未被隔离的平均天数为3.5天。这些差异具有统计学意义。住院时间也相应缩短。此外，患者和工作人员的士气和态度有明显改善。
结核病治疗小组可能通过增加入住抗酸杆菌隔离病房的传染性肺结核患者比例以及减少（780天）痰涂片阳性时未被隔离的天数，降低了医院内结核病传播的风险。同时也节省了费用。
