ABSTRACT
Objetivo: Evaluar la adecuación del aislamiento y la respuesta microbiológica al tratamiento en pacientes con tuberculosis (TB).Métodos: Determinaciones: 1. Adecuación del aislamiento: hospitalario (sospecha diagnóstica y aislamiento desde la admisión en la planta de hospitalización) o domiciliario (diagnóstico y tratamiento tras el alta en urgencias y aislamiento en el domicilio 15 días). 2. Influencia del tratamiento en el estado bacteriológico del esputo. Resultados: 1. De 100 pacientes consecutivos con TB, 50 tenían baciloscopia +, 37 de ellos tenían aislamiento correcto (28 hospitalario, 9 domiciliario). En los 13 restantes el aislamiento fue incorrecto,3 domiciliario (dos alta sin aislamiento y retraso diagnóstico de 7 y 10 días, otro con aislamiento 10días) y 10 ingresados (retraso de 1-14 días, media 4.5; en 5 retraso de un día y en los 5 restantes retraso de 3 a 14 días). 2. De 50 pacientes con baciloscopia + en 14 se realizó control microbiológicoal mes del inicio del tratamiento (todos baciloscopia +, 10 cultivo +). En 25 con control al 2º mes, 8baciloscopia +, 7 Cultivo +.Conclusiones: 1. Se ha objetivado que en el 13% de los pacientes con TB no se realizó el aislamiento correctamente. 2. En pacientes con TB bacilífera, tras uno o dos meses de tratamiento existe un número importante con baciloscopia y cultivo +. Se deben controlar la política de aislamiento y la respuesta microbiológica al tratamiento por la influencia que pueden tener en la transmisión de la TB (AU)
Aim: To know 1º. The respiratory isolation policy, 2º. The effect of treatment on the sputum bacteriologic status in patients with tuberculosis (TB).Methods: 1. Description of isolation policies. We defined correct isolation in hospital as diagnosis suspicion and isolation on admission and duration no less than 15 days and correct domiciliary isolation as diagnosis in emergency room with recommendation of treatment and stay at home at least 15days. 2. Follow-up of sputum status after treatment. Results: 1. 100 consecutive patients, sputum smear + in 50, 37 with correct isolation (28 in hospital and 9 domiciliary). In 13 with incorrect isolation, 3 were outpatients (2 without diagnosis neither isolation and delay in diagnosis of 7 and 10 days and another with domiciliary isolation of 10 days). In10 inpatients the diagnosis delay was 1 to 14 days (mean 4.5). 2. Fifty positive smear patients were followed-up for bacteriology controls. First month control on 14 showed positive smear for all and positive culture for 10 of them. Second month control was performed on 25, 8 of them were smear positive and 7 culture positive. Conclusions: 1. In 13% of patients with TB we did not perform the isolation correctly. 2. There was a high rate of positives smear and culture after one and two months of treatment within TB patients with initial positive smear. We must control isolation policy and bacteriologic response to treatment because of the influence that can have in TB transmission (AU)
Subject(s)
Humans , Sputum/microbiology , Tuberculosis/microbiology , Mycobacterium tuberculosis/isolation & purification , Patient Isolation , Disease Transmission, Infectious/prevention & controlABSTRACT
The increase in the hope and quality of life, along with the greater rapidity and comfort of the different means of transport have made possible that travellers with chronic diseases, pregnant and kids makes tourist trips to tropical or subtropical zones. On the other hand the increase of the international cooperation has caused the appearance of long stay travellers who live in conditions such as the local population. These travellers have special characteristics due to their physical training conditions, chronic treatments, or the way of life during the travel that them makes more susceptible to suffer problems of health during the travel. For this reason the usual recommendations for travellers are insufficient in these groups and is necessary to make an individualized travel advice that considers these factors. This revision shows the most important warnings that must be made in these groups of special travellers.
Subject(s)
Health Promotion , Travel , Disease Management , Guidelines as Topic , Humans , Immunization , Tropical MedicineABSTRACT
El aumento de la esperanza y calidad de vida, junto con la mayor rapidez y comodidad de los distintos medios de transporte, ha posibilitado que viajeros con enfermedades crónicas, embarazadas o niños emprendan viajes turísticos a zonas tropicales o subtropicales. Por otra parte, el aumento de la cooperación internacional ha propiciado la aparición de viajeros de larga estancia que viven en condiciones similares a las de la población local. Estos viajeros presentan una serie de características especiales, debidas a sus condiciones físicas, tratamientos habituales o tipo de condiciones de vida durante el viaje, que les hacen más susceptibles de presentar algún tipo de problema de salud durante el viaje. Por este motivo, las recomendaciones habituales para viajeros son insuficientes en estos grupos y es preciso realizar un consejo al viajero individualizado que tenga en cuenta estos factores. En esta revisión se presentan de forma resumida las principales advertencias que deben realizarse en estos grupos de viajeros especiales
The increase in the hope and quality of life, along with the greater rapidity and comfort of the different means of transport have made possible that travellers with chronics diseases, pregnant and kids makes tourist trips to tropical or subtropical zones. On the other hand the increase of the international cooperation has caused the appearance of long stay travellers who live in conditions such as the local population. These travellers have special characteristics due to their physical training conditions, chronics treatments, or the way of life during the travel that them makes more susceptible to suffer problems of health during the travel. For this reason the usual recommendations for travellers are insufficient in these groups and is necessary to make an individualized travel advice that considers these factors. This revision shows the most important warnings that must be made in these groups of special travellers
