Jung Seop Eom1, Geewon Lee2, Jeong Ha Mok1 and Min Ki Lee1
1Department of Internal Medicine, Pusan
National University School of Medicine, Busan, Republic of Korea, 2Department of Radiology, Pusan National
University School of MedicineRepublic
Guidelines recommend the use by healthcare personnel of a fit-tested
N95 particulate respirator when pulmonary tuberculosis (PTB) is
suspected in a patient undergoing bronchoscopy. However, Mycobacterium
tuberculosis (MTB) infection may be unsuspected
setting and therefore not evaluated, resulting in the unexpected
exposure to MTB by healthcare workers in the bronchoscopy suite.
We examined the incidence of unexpected exposure to MTB during
bronchoscopy and determined the exposure-related factors.
retrospective study was conducted based on 1650 patients who underwent
bronchoscopy for suspicious respiratory disease other than PTB.
The results of bronchial washing, bronchoalveolar lavage, and
post-bronchoscopic sputum were reviewed.
PTB was unexpectedly diagnosed in 76 patients (4.6%). The presence of
anthracofibrosis (OR, 3.878; 95% CI, 1.291?11.650; P
= 0.016), bronchiectasis (OR, 1.974; 95% CI, 1.095?3.557; P
= 0.024), or atelectasis (OR, 1.740; 95% CI, 1.010?2.903; P
= 0.046) on CT was independently associated with unexpected PTB.
The risk of MTB exposure by healthcare personnel in the bronchoscopy
suite due to patients with undiagnosed PTB has been underestimated.
Therefore, higher-grade respiratory precaution should be considered in
the bronchoscopic evaluation of patients with CT-confirmed
anthracofibrosis, bronchiectasis, or atelectasis.