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  • Title: Missed TB in AIDS unit leads to tighter isolation.
    Journal: AIDS Alert; 1996 Aug; 11(8):91-3. PubMed ID: 11363656.
    Abstract:
    The San Francisco General Hospital recently tightened its tuberculosis (TB) policies for isolating HIV-positive patients after learning that active TB patients had been admitted without respiratory protection. The new policy resulted from what was initially believed to be a TB outbreak on the AIDS unit. However, an investigation concluded that the patients were infected outside the hospital. The hospital now automatically screens patients for TB when they are admitted to the AIDS ward. HIV-positive patients who are put on rule-out for TB cannot be admitted to the AIDS unit until they have three negative sputum smears. Low-risk, suspected TB patients now are put in a private room with negative air pressure. This new policy will cost the hospital more money. Using the rapid assay test for sputum-positive cases that are likely to be Mycobacterium avium complex (MAC) would cut isolation time and money. However, the test is only 95 percent sensitive, so one out of 20 patients could be missed. The city will be making a decision about whether the new test will be used under these circumstances.
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