Abstract:

Objective: To analyze the status of discovery of pulmonary tuberculosis with positive etiology among unknown pulmonary tuberculosis and suspected patients hospitalized in the respiratory department of a general hospital in Longhua, Shenzhen from 2018 to 2020, and explore the mode of early detection of pulmonary tuberculosis among hospitalized patients in the respiratory department. Methods: From January 2018 to December 2020, a sputum retention room was set up in a general hospital in Longhua, equipped with full-time personnel for sputum retention education to collect sputum from unknown pulmonary tuberculosis and suspected patients who had suspected symptoms or other hospitalized patients with pulmonary tuberculosis could not be excluded clinically (n=342)(or collecting bronchoalveolar lavage fluid or pleural effusion by medical staff). Smear, culture and GeneXpert MTB/RIF (“GeneXpert”) test were conducted at the same time to detect the pulmonary tuberculosis patients with positive etiology, and the value of different test strategies in the detection of patients with positive etiology was analyzed. Results: Of the 342 patients, etiology was positive in 73 (21.3%). With single test method, 24 patients (32.9%, 24/73) were found positive by smears, 52 (71.2%,52/73) by culture, and 54 (74.0%, 54/73) by GeneXpert. With combination of test methods, 53 patients (72.6%, 53/73) were found positive by sputum smear+sputum culture test, 58 patients (79.5%, 58/73) were found positive by sputum smear+GeneXpert test, and 73 patients (100.0%, 73/73) were found positive by sputum culture+GeneXpert. The positive rate of pathogens was the highest in 2020 (27.7%, 38/137), followed by 2018 (20.6%, 20/97) and 2019 (13.9%, 15/108), with statistical significance (χ²=6.941, P=0.031). Conclusion: Among the inpatients in the respiratory department of general hospitals, beside those who with known pulmonary tuberculosis and those who with pulmonary tuberculosis-related images indicated by chest imaging examination, pulmonary tuberculosis patients with positive etiology still existed. It was suggested that the general hospital cooperate with local institutions with detection ability to keep sputum for examination before diagnostic treatment, so as to move forward the detection of pulmonary tuberculosis patients with positive etiology.

Key words: Tuberculosis,pulmonary, Early diagnosis, Hospitals,general, Evaluation studies