Article Text
Abstract
Background Controlling and preventing tuberculosis (TB) continues to be a major public healthcare challenge. Pharmacy and clinical records can thus contribute with important information concerning newly-diagnosed inpatients, treatment regimens and resistant strains.
Purpose To identify new tuberculosis (TB) cases through prescription records in a Portuguese General Hospital.
Materials and Methods This study took place in 2012, in Hospital Prof Dr Fernando Fonseca EPE (HFF), an 800-bed hospital. Patients were identified from Pharmacy dispensing records (Hosix v7.1; SIVSA) and clinical information was collected from the electronic medical records (Soarian Clinicals 3.1; Siemens). This data covered: age, sex, signs and symptoms, risk factors, outcomes of chest X-ray, diagnosis, respiratory isolates, therapeutic and microbiology results.
Results To the end of September 2012 75 new cases of TB were identified. 38 diagnoses were made up to 24 h after hospital admission. The most frequent symptoms were non-productive cough 65.8%, weight loss 55.3% and fever 50%. There were 26 cases of pulmonary TB and 12 of extrapulmonary TB. 23 patients tested positive to the Ziehl Neelsen stain. 2 of the patients had resistant TB. 37 patients were diagnosed up to a maximum period of 10 weeks after hospital admission. The most frequent symptoms were non-productive cough 40.5%, weight loss 40.5% and fever 37.8%. There were 16 cases of pulmonary TB, 13 extrapulmonary and 8 strictly clinical and imaging diagnoses. 3 patients tested positive to Ziehl Neelsen. 2 of the patients had resistant TB. By the time of the congress data will be updated for the year 2012.
Conclusions The high rate of delayed-diagnosis TB contributes to an increase risk for the health care workers and other patients exposed to it. The hospital OHD used this study to demonstrate the importance of early diagnosis in the Emergency Department and faster microbiology results and of putting suitable isolation measures in place.
No conflict of interest.