Risk factors for non-isolation of patients admitted for pulmonary tuberculosis in a high-incidence département: a single-center retrospective study.

Pulmonary tuberculosis (PT) is an airborne disease, justifying the identification of suspect patients on admission, and their hospitalization in individual rooms with the implementation of Airborne Supplementary Precautions (ASP). The aim of this study was to identify, in a high-prevalence hospital, the frequency of non-isolated PT and the factors associated with the delay in implementing ASP. This was a retrospective observational study, including patients with at least one Mycobacterium tuberculosis-positive specimen. Patient demographic and clinical data, as well as data related to the mode of admission, were collected. Univariate and multivariate statistical analyses were performed. During the study period, 256 patients were included. Among them 134 (52.3%) had PT. These included 100 (75%) men, median age 39, 70% foreign-born. Among these patients, 46 (34%) were isolated beyond the 24th hour of admission. The average time to implement ASP was 4.3 days, and 7 patients (5.2%) were not isolated throughout their stay. Three classes of factors were associated by multivariate analysis with isolation. Previous consultation with a general practitioner was protective whereas admission through emergency department was not. Presence of so-called cardinal clinical signs and a suggestive chest X-ray were protective factors. Finally, European patients were less frequently isolated. In our study, 34% of patients admitted with PT were not isolated on admission. The risk of non-isolation was 3 times higher in cases of admission via the emergency department, and European patients were less well isolated. The presence of cardinal signs and prior consultation with a general practitioner were associated with a higher frequency of isolation.

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