Publication: Nosocomial TB in two neonatal intensive care units at a tertiary care centre: Infection risk and outcomes
Issued Date
2021-07-01
Resource Type
ISSN
18157920
10273719
10273719
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2-s2.0-85108963313
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Tuberculosis and Lung Disease. Vol.25, No.7 (2021), 567-572
Suggested Citation
B. Yangthara, P. Wutthigate, S. Roongmaitree, P. Siripattanapipong, K. Lapphra, R. Kitsommart, W. Phongsamart, S. Ngerncham, O. Wittawatmongkol, P. Wongsiridach, K. Chokephaibulkit Nosocomial TB in two neonatal intensive care units at a tertiary care centre: Infection risk and outcomes. International Journal of Tuberculosis and Lung Disease. Vol.25, No.7 (2021), 567-572. doi:10.5588/ijtld.21.0060 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78074
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Title
Nosocomial TB in two neonatal intensive care units at a tertiary care centre: Infection risk and outcomes
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Abstract
BACKGROUND: Sick neonates in TB endemic areas are at risk of nosocomial TB exposure. OBJECTIVE: To evaluate outcomes following contact investigation and isoniazid preventive treatment (IPT) in sick neonates exposed to healthcare personnel (HCP) with pulmonary TB. METHODS: Investigations were conducted following two exposure events in different neonatal intensive care units (NICUs). Details of the infants' physical examination, chest X-ray and exposure history were recorded. Infants without TB disease were prescribed a 9-month course of IPT and followed for ≥1 year. RESULTS: Ninety infants were exposed in NICU A and 231 in NICU B (n ¼ 321). The overall proportions of completing the 9-month IPT was 164/265 (61.8%): 40/ 79 (50.6%) in NICU A and 124/186 (66.7%) in NICU B (P ¼ 0.01). The overall incidence of TB was 10.2% (24/ 236): 7.5% in NICU A and 11.2% in NICU B (P ¼ 0.39). Contact investigation beginning .111 days after exposure was a risk factor for TB infection (P ¼ 0.02). CONCLUSION: The risk of TB following nosocomial exposure in sick neonates was high, particularly when contact investigation was delayed. Our findings underscore the importance of hospital policies that promote early detection of TB in HCP, reduce transmission in NICUs, and facilitate rapid case investigation.