Abstract
Healthcare Associated Infection (HAI) by tuberculosis is still a serious problem in Japan. In our hospital, 3 patients were newly diagnosed with pulmonary tuberculosis after admission in 2009, and many resources were needed for the surveillance of exposed individuals. For the early detection of tuberculosis, we have continued routine Acid-Fast Bacillus (AFB) smear examinations in elderly (older than 60 years old) inpatients when sputum cultures are ordered since September 2010. A total of 2646 additional routine AFB smears were examined without orders from the physicians in charge from September 2010 to December 2014. Five specimens (0.19%) were revealed as AFB positive. After intervention, the total number of exposed individuals for the surveillance of tuberculosis were reduced by 56, from 152 to 96, but the numbers of such individuals per patient with tuberculosis were not significantly different. The saving in cost for the survey per individual was about 868 yen, rather lower than the cost of surveillance per individual of about 2933 yen. Early detection is vital to prevent HAI by tuberculosis based on screening examinations. This study shows that routine AFB testing both on admission and during hospital stay may be useful for the early detection of tuberculosis and saving of costs for contact surveys. In addition, we suggest that maintenance of the support system of diagnosis and education about tuberculosis for physicians should be included in future infection measures.
