Pulmonary tuberculosis and management of contact patients in a department of nephrology and kidney transplantation
International Journal of Infectious Diseases May 27, 2021
Burguet L, Duvignaud A, Nguyen D, et al. - Researchers aimed at delineating the investigation, follow-up, management and outcomes in a cohort of chronic kidney disease and kidney transplant recipients exposed to a case of pulmonary tuberculosis. They followed the concentric circles approach to investigate the contacts and followed them up according to their level of priority. In those with evidence of latent tuberculous infection, consideration was given to the level of exposure, individual vulnerability, as well as the results of an IGRA (interferon γ release assay), for making treatment decisions. They identified 130 patients with chronic kidney disease and 180 kidney transplant recipients as contacts; their follow-up was performed over a 2-year period. Only contacts of circle 1 or with positive IGRA were provided tuberculosis treatment. This cohort of immunocompromised patients had occurrence of no case of tuberculosis disease. Questions remain concerning systematic tuberculosis prophylaxis on highly vulnerable contact.
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