A current review of infection control for childhood tuberculosis
Department of Pediatrics, Baylor College of Medicine, 6621 Fannin Street, Suite A2210, MC 1-1481, Houston, TX 77030, USA. Tuberculosis (Edinburgh, Scotland)
(Impact Factor: 2.71).
11/2011; 91 Suppl 1:S11-5. DOI: 10.1016/j.tube.2011.10.004
Tuberculosis (TB) infection control recommendations in healthcare settings were developed to decrease nosocomial transmission from adults. In the absence of pediatric-specific guidelines, these infection control recommendations have been incorporated, in almost unmodified format, for childhood TB. We will review the evidence concerning the contagiousness of TB in children, scenarios in which transmission is more likely, review United States national recommendations, and consider the family unit, as opposed to the patient, to be the transmission unit for childhood TB.
Available from: Carole Ridge
Seminars in roentgenology 04/2012; 47(2):182-96. DOI:10.1053/j.ro.2011.12.002 · 0.71 Impact Factor
Available from: atsjournals.org
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ABSTRACT: The management of children with drug-resistant (DR) tuberculosis (TB) is challenging and it is likely that in many places the roll-out of molecular diagnostic testing will lead to more children being diagnosed. There is a limited evidence base to guide optimal treatment and follow-up in the pediatric population; in existing DR-TB guidelines the management of children is often relegated to small 'special populations' sections. This article seeks to address this gap by providing clinicians with practical advice and guidance. This is achieved through review of the available literature on pediatric DR-TB, including research studies and international guidelines, combined with consensus opinion from a team of experts who have extensive experience in the management of children with DR-TB in a wide variety of contexts and with varying resources. The review covers treatment initiation, regimen design and treatment duration, management of co-morbid conditions, treatment monitoring, adverse events, adherence promotion, and infection control, all within a multidisciplinary environment.
American Journal of Respiratory and Critical Care Medicine 09/2012; 186(10). DOI:10.1164/rccm.201206-1001CI · 13.00 Impact Factor
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Regular monitoring of latent tuberculosis (TB) infection in healthcare workers (HCWs) is recommended, but the view about the effective method and performance of serial monitoring is controversial. The aim of this study was to determine differences in conversion rates according to TB exposure risk using the tuberculin skin test (TST) and the QuantiFERON-TB Gold In-Tube (QFT-GIT), and to evaluate the reproducibility and within-subject variability of the QFT-GIT in South Korea.
Fifty-three HCWs were grouped according to their risk for TB exposure: group 1, high risk (n = 21); group 2, low risk (n = 32). Baseline and follow-up TSTs and QFT-GITs were performed from June 2009 to July 2011. Enzyme-linked immunosorbent assays (ELISAs) were repeated for the second QFT-GIT and a third QFT-GIT was performed after 8 weeks when discordant results of the second TST and QFT-GIT or a conversion or reversion were observed.
No difference in the QFT-GIT conversion rate was evident between the two groups (15.4 vs. 6.5 %, p = 0.57), and no TST conversion was observed. The rate of QFT-GIT positivity was higher in the high-risk group (first QFT-GIT: 38.1 vs. 3.1 %, p = 0.002; second QFT-GIT: 33.3 vs. 9.4 %, p = 0.039). The re-test reproducibility of QFT-GIT results was high (100 %), and the within-subject results of repetitive QFT-GITs were variable.
Stricter prevention strategies remain necessary in HCWs at high risk of TB exposure, and serial interferon-γ release assays (IGRAs) should be interpreted with caution in HCWs.
Infection 10/2012; 41(2). DOI:10.1007/s15010-012-0356-0 · 2.62 Impact Factor
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