Tuberculosis screening in a dialysis unit: detecting latent tuberculosis infection is only half the problem

S O Brij; S C Beck; F Kleemann; A L Jack; C Wilkinson; D A Enoch

doi:10.1016/j.jhin.2014.05.008

Tuberculosis screening in a dialysis unit: detecting latent tuberculosis infection is only half the problem

J Hosp Infect. 2014 Aug;87(4):241-4. doi: 10.1016/j.jhin.2014.05.008. Epub 2014 Jun 24.

Authors

S O Brij¹, S C Beck¹, F Kleemann¹, A L Jack¹, C Wilkinson¹, D A Enoch²

Affiliations

¹ Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK.
² Peterborough & Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK. Electronic address: [email protected].

PMID: 25027226
DOI: 10.1016/j.jhin.2014.05.008

Abstract

Patients with chronic kidney disease are at increased risk of tuberculosis. We describe the events that occurred when we encountered a patient receiving haemodialysis with pulmonary tuberculosis. Nine (of 41) patients dialysing at the same time as the index case had a positive interferon-gamma release assay (IGRA) and were offered therapy for latent tuberculosis infection (LTBI). Patients with an initial negative IGRA were rescreened at six months, identifying a further three IGRA-positive patients. All patients were then rescreened at 12 months. No new IGRA-positive cases were identified and no staff or patients developed active disease. Only five of the 12 IGRA-positive patients completed LTBI therapy.

Keywords: Dialysis; Interferon-gamma release assay; Tuberculosis.

Publication types

Case Reports

MeSH terms

Antitubercular Agents / therapeutic use
Drug Monitoring / methods
Hemodialysis Units, Hospital
Humans
Interferon-gamma Release Tests
Latent Tuberculosis / diagnosis*
Latent Tuberculosis / drug therapy
Latent Tuberculosis / epidemiology*
Male
Mass Screening / methods*
Middle Aged
Treatment Outcome

Substances

Antitubercular Agents