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Preterm Twins Born to a Mother with Miliary Tuberculosis: Importance of Early Recognition and Prompt Response in Infection Control to Manage Congenital Tuberculosis Exposure in a Neonatal Intensive Care Unit
- Source :
- Japanese journal of infectious diseases. 74(2)
- Publication Year :
- 2020
-
Abstract
- Delayed diagnosis of congenital tuberculosis (TB) in the neonatal intensive care unit (NICU) is a serious problem in terms of infection control. Here, we report our preemptive infection control activities implemented after the diagnosis of miliary TB in a mother of preterm twins (index twins, NB1 and NB2) in the NICU. In addition, we reviewed previous case reports of congenital TB exposure in the NICU setting. Immediately after diagnosing miliary TB in the mother, the index twins were isolated before their TB diagnosis and received preemptive anti-TB medication; contact investigations were also conducted. Eventually, NB1 was diagnosed with congenital TB at 29 days of age, and NB2 showed no definite evidence of TB. Through contact investigation, 11 of the 16 exposed infants received isoniazid prophylaxis and no positive tuberculin skin test results were obtained after 3 months. One of the 31 exposed healthcare workers showed new interferon-gamma release assay conversion. Moreover, our case showed a much shorter contagious period compared to that in previous reports (8 versus 17-102 days). This suggests that a high index of suspicion and prompt measures can help prevent congenital TB outbreaks and reduce the burden of infection control activities in the NICU.
- Subjects :
- 0301 basic medicine
Microbiology (medical)
Adult
Male
Pediatrics
medicine.medical_specialty
Miliary tuberculosis
Neonatal intensive care unit
Health Personnel
030106 microbiology
Antitubercular Agents
Twins
Mothers
Infant, Premature, Diseases
Delayed diagnosis
03 medical and health sciences
0302 clinical medicine
Intensive Care Units, Neonatal
medicine
Isoniazid
Infection control
Humans
Tuberculosis
030212 general & internal medicine
Infection Control
business.industry
Tuberculin Test
Tuberculosis, Miliary
Infant, Newborn
POSITIVE TUBERCULIN
General Medicine
Mycobacterium tuberculosis
medicine.disease
Tb exposure
Infectious Disease Transmission, Vertical
Infectious Diseases
Treatment Outcome
Female
Contact Tracing
business
Post-Exposure Prophylaxis
Congenital tuberculosis
Infant, Premature
medicine.drug
Subjects
Details
- ISSN :
- 18842836
- Volume :
- 74
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Japanese journal of infectious diseases
- Accession number :
- edsair.doi.dedup.....dd45f5c1e77cfe78d36a3efcada5891c