Use of acid-fast bacilli staining to determine the need for airborne infection isolation precautions: a comparison of respiratory specimens

Christina Silkaitis; Laura Bardowski; Cara Coomer; Kathryn Trakas; Mary Alice Lavin; Susheel Reddy; Maureen K Bolon; Teresa R Zembower

doi:10.1016/j.ajic.2014.08.005

Use of acid-fast bacilli staining to determine the need for airborne infection isolation precautions: a comparison of respiratory specimens

Am J Infect Control. 2014 Nov;42(11):1244-6. doi: 10.1016/j.ajic.2014.08.005. Epub 2014 Sep 22.

Authors

Christina Silkaitis¹, Laura Bardowski², Cara Coomer³, Kathryn Trakas⁴, Mary Alice Lavin⁵, Susheel Reddy⁶, Maureen K Bolon⁷, Teresa R Zembower⁷

Affiliations

¹ Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL. Electronic address: csilkait@nmh.org.
² Infection Prevention and Control, Rush University Medical Center, Chicago, IL.
³ Epidemiology and Infection Control, Advocate Good Samaritan Hospital, Downers Grove, IL.
⁴ BD Diagnostics, Sparks, MD.
⁵ Infection Control, Saint Anthony Hospital, Chicago, IL.
⁶ Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
⁷ Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL; Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.

PMID: 25248484
DOI: 10.1016/j.ajic.2014.08.005

Abstract

Institution of appropriate airborne infection isolation (AII) precautions for patients with suspected Mycobacterium tuberculosis is critical to prevent disease transmission. We compared the yield of acid-fast bacilli smears from different types of respiratory specimens and found that smear sensitivity was highest for specimens obtained by endotracheal aspirates (92%), followed by sputum (79%), and then by bronchoalveolar lavage (37%). As a result of this study, our institutional policy regarding discontinuation of AII precautions was amended.

Keywords: Acid-fast bacilli; Isolation precautions; Mycobacterium tuberculosis; Respiratory specimens.

MeSH terms

Bacteriological Techniques / methods*
Bodily Secretions / microbiology
Bronchoalveolar Lavage Fluid / microbiology
Disease Transmission, Infectious / prevention & control*
Humans
Mycobacterium tuberculosis / isolation & purification*
Patient Isolation*
Retrospective Studies
Sputum / microbiology
Staining and Labeling / methods*
Tuberculosis, Pulmonary / microbiology*
Tuberculosis, Pulmonary / transmission*