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

• Published in: The Journal of hospital infection Vol. 87; no. 4; pp. 241 - 244
• Main Authors: Brij, S.O, Beck, S.C, Kleemann, F, Jack, A.L, Wilkinson, C, Enoch, D.A
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.08.2014; Elsevier
• Subjects: Antitubercular Agents - therapeutic use; Bacterial diseases; Biological and medical sciences; Dialysis; Drug Monitoring - methods; Hemodialysis Units, Hospital; Human bacterial diseases; Humans; Infectious Disease; Infectious diseases; Interferon-gamma release assay; Interferon-gamma Release Tests; Latent Tuberculosis - diagnosis; Latent Tuberculosis - drug therapy; Latent Tuberculosis - epidemiology; Male; Mass Screening - methods; Medical sciences; Middle Aged; Treatment Outcome; Tuberculosis; Tuberculosis and atypical mycobacterial infections; United Kingdom > UK; England; Dialysis; Tuberculosis; Interferon-gamma release assay; Infection; Latent tuberculosis; Medical screening; Release; Public health; Gamma interferon
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2014.05.008

Summary 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.