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학술저널
저자정보
허대혁 (서울대학교) 서준원 (서울대학교) 김정한 (서울대학교) 전준영 (서울대학교 의과대학 내과학교실) 준강일 (서울대학교) 강창경 (서울대학교 의과대학 내과학교실) 문송미 (서울대학교) 송경호 (분당서울대학교병원) 최평균 (서울대학교병원) 박완범 (서울대학교병원) 방지환 (서울대학교 의과대학 서울대학교병원 내과) 김의석 (분당서울대학교병원) 박상원 (서울대학교) 김남중 (서울대학교) 오명돈 (서울대학교) 김홍빈 (서울대학교)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.34 No.43
발행연도
2019.1
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1 - 8 (8page)

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Background: Delays in isolating patients admitted to hospital with active pulmonary tuberculosis (PTB) can contribute to nosocomial transmission; however, in Korea, patients with clinically diagnosed PTB are not routinely isolated while awaiting microbiological confirmation of the diagnosis. We aimed to assess the extent of delays in isolating patients admitted with PTB and to identify the factors associated with delayed isolation. Methods: We retrospectively reviewed the electronic medical records of patients aged ≥ 18 years with active PTB, between January 2008 and December 2017, from two Korean hospitals. Results: Among 1,062 patients, 612 (57.6%) were not isolated on admission day. The median time from admission to isolation was 1 day (interquartile range: 0–2 days). The independent risk factor most strongly associated with delayed isolation was admission to departments other than pulmonology or infectious diseases departments (adjusted odds ratio [aOR], 5.302; 95% confidence interval [CI], 3.177–8.847; P < 0.001). Factors associated with isolation on admission day were a past history of tuberculosis (TB) (aOR, 0.669; 95% CI, 0.494–0.906; P = 0.009), night sweats (aOR, 0.530; 95% CI, 0.330–0.851; P = 0.009), and apical infiltrates on chest radiographs (aOR, 0.452; 95% CI, 0.276–0.740; P = 0.002). Conclusion: Concerning patients subsequently diagnosed with active PTB, > 50% were not isolated on admission day. We suggest that the patients with clinically suspected PTB including the elderly who have a past history of TB, night sweats, or apical infiltration on chest radiographs, be presumptively isolated on admission, without waiting for microbiological confirmation of the diagnosis.

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