Switching from expectorated to induced sputum cultures for tuberculosis diagnosis reduces cost without increasing risk

Qasim A Mohiuddin; Leighanne Parkes; Michael Gardam

doi:10.1016/j.ajic.2019.01.005

Switching from expectorated to induced sputum cultures for tuberculosis diagnosis reduces cost without increasing risk

Am J Infect Control. 2019 Aug;47(8):1022-1024. doi: 10.1016/j.ajic.2019.01.005. Epub 2019 Feb 20.

Authors

Qasim A Mohiuddin¹, Leighanne Parkes², Michael Gardam³

Affiliations

¹ Infection Prevention and Control, University Health Network, Toronto, ON, Canada. Electronic address: qasim.mohiuddin@uhn.ca.
² Division of Infectious Diseases and Department of Medicine, Jewish General Hospital, Montréal, QC, Canada; Infection Prevention and Control, CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montréal, QC, Canada.
³ Tuberculosis Clinic, Toronto Western Hospital, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada.

PMID: 30795839
DOI: 10.1016/j.ajic.2019.01.005

Abstract

Active pulmonary tuberculosis testing with 3 expectorated sputa can increase isolation days and expenditures compared with 1 induced sputum. Six-month retrospective and prospective chart reviews were conducted, and a screening algorithm was phased into 2 hospital sites. With induced sputum testing, isolation decreased from 7 to 4 days (interquartile range, 4-3, P = .0135), and there was a cost savings of $7,275 per case, with no added harm.

Keywords: Airborne precautions; Expenditures; General medicine; Isolation days; Screening algorithm; TB.

MeSH terms

Aged
Bacteriological Techniques / economics
Bacteriological Techniques / methods*
Bacteriological Techniques / standards*
Female
Humans
Male
Mycobacterium tuberculosis / isolation & purification*
Prospective Studies
Retrospective Studies
Sputum / microbiology*
Tuberculosis, Pulmonary / diagnosis*
Tuberculosis, Pulmonary / microbiology*