array:24 [
  "pii" => "S0873215915303767"
  "issn" => "08732159"
  "doi" => "10.1016/S0873-2159(15)30376-7"
  "estado" => "S350"
  "fechaPublicacion" => "2007-11-01"
  "aid" => "3"
  "copyright" => "Sociedade Portuguesa de Pneumologia/SPP"
  "copyrightAnyo" => "2007"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Pneumol. 2007;13:789-99"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2688
    "formatos" => array:3 [
      "EPUB" => 210
      "HTML" => 1844
      "PDF" => 634
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0873215915303810"
    "issn" => "08732159"
    "doi" => "10.1016/S0873-2159(15)30381-0"
    "estado" => "S350"
    "fechaPublicacion" => "2007-11-01"
    "aid" => "8"
    "copyright" => "Sociedade Portuguesa de Pneumologia/SPP"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2007;13:869-77"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2708
      "formatos" => array:3 [
        "EPUB" => 234
        "HTML" => 1791
        "PDF" => 683
      ]
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Caso Cl&#237;nico &#47; Clinical Case</span>"
      "titulo" => "A tuberculose multirresistente e a rainha vermelha &#8211; A rapidez do diagn&#243;stico &#233; decisiva"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "869"
          "paginaFinal" => "877"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Multi-drug resistant tuberculosis and the red queen &#8211; Diagnosis speed is crucial"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jo&#227;o Costeira, Jaime Pina"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Costeira"
            ]
            1 => array:2 [
              "nombre" => "Jaime"
              "apellidos" => "Pina"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915303810?idApp=UINPBA00004E"
    "url" => "/08732159/0000001300000006/v1_201509151528/S0873215915303810/v1_201509151528/pt/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0873215915303755"
    "issn" => "08732159"
    "doi" => "10.1016/S0873-2159(15)30375-5"
    "estado" => "S350"
    "fechaPublicacion" => "2007-11-01"
    "aid" => "2"
    "copyright" => "Sociedade Portuguesa de Pneumologia&#47;SPP"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Pneumol. 2007;13:775-87"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2393
      "formatos" => array:3 [
        "EPUB" => 208
        "HTML" => 1497
        "PDF" => 688
      ]
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original &#47; Original Article</span>"
      "titulo" => "Tromboembolismo pulmonar e asma de dif&#237;cil controlo"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "pt"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "775"
          "paginaFinal" => "787"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Pulmonary embolism and difficult-to-treat asthma"
        ]
      ]
      "contieneResumen" => array:2 [
        "pt" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Catarina Teles Martins, Carlos Lopes, Alda Manique, Dolores Moniz, Renato Sotto-Mayor, A Bugalho de Almeida"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Catarina Teles"
              "apellidos" => "Martins"
            ]
            1 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Lopes"
            ]
            2 => array:2 [
              "nombre" => "Alda"
              "apellidos" => "Manique"
            ]
            3 => array:2 [
              "nombre" => "Dolores"
              "apellidos" => "Moniz"
            ]
            4 => array:2 [
              "nombre" => "Renato"
              "apellidos" => "Sotto-Mayor"
            ]
            5 => array:2 [
              "nombre" => "A Bugalho"
              "apellidos" => "de Almeida"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915303755?idApp=UINPBA00004E"
    "url" => "/08732159/0000001300000006/v1_201509151528/S0873215915303755/v1_201509151528/pt/main.assets"
  ]
  "pt" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo Original &#47; Original Article</span>"
    "titulo" => "Tuberculose em profissionais de sa&#250;de de um servi&#231;o hospitalar"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "789"
        "paginaFinal" => "799"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Sandra Saleiro, Ana Rosa Santos, Ot&#237;lia Vidal, Teresa Carvalho, Jos&#233; Torres Costa, Jos&#233; Agostinho Marques"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "Sandra"
            "apellidos" => "Saleiro"
            "email" => array:1 [
              0 => "sandrasaleiro&#64;portugalmail&#46;pt"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">1</span>"
                "identificador" => "af0005"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cr0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Ana Rosa"
            "apellidos" => "Santos"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Ot&#237;lia"
            "apellidos" => "Vidal"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">2</span>"
                "identificador" => "af0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Teresa"
            "apellidos" => "Carvalho"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">3</span>"
                "identificador" => "af0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jos&#233; Torres"
            "apellidos" => "Costa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">4</span>"
                "identificador" => "af0020"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Jos&#233; Agostinho"
            "apellidos" => "Marques"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">5</span>"
                "identificador" => "af0025"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Interna Complementar de Pneumologia &#47; <span class="elsevierStyleItalic">Pulmonology resident&#44;</span> Servi&#231;o de Pneumologia &#8211; Hospital de S&#227;o Jo&#227;o &#47; <span class="elsevierStyleItalic">Pulmonology Unit &#8211; Hospital de S&#227;o Jo&#227;o</span> Director de Servi&#231;o&#58; Prof&#46; Doutor Jos&#233; Agostinho Marques &#47; <span class="elsevierStyleItalic">Director&#58; Prof&#46; Doutor Jos&#233; Agostinho Marques</span>"
            "etiqueta" => "1"
            "identificador" => "af0005"
          ]
          1 => array:3 [
            "entidad" => "Assistente Hospitalar Graduada de Pneumologia &#47; <span class="elsevierStyleItalic">Pulmonology consultant&#44;</span> Servi&#231;o de Pneumologia &#8211; Hospital de S&#227;o Jo&#227;o &#47; <span class="elsevierStyleItalic">Pulmonology Unit &#8211; Hospital de S&#227;o Jo&#227;o</span> Director de Servi&#231;o&#58; Prof&#46; Doutor Jos&#233; Agostinho Marques &#47; <span class="elsevierStyleItalic">Director&#58; Prof&#46; Doutor Jos&#233; Agostinho Marques</span>"
            "etiqueta" => "2"
            "identificador" => "af0010"
          ]
          2 => array:3 [
            "entidad" => "Assessora Superior de Sa&#250;de&#59; Licenciada em Farm&#225;cia &#47; <span class="elsevierStyleItalic">Senior health care assistant&#59; Pharmacy graduate&#44;</span> Servi&#231;o de Microbiologia &#8211; Hospital de S&#227;o Jo&#227;o &#47; <span class="elsevierStyleItalic">Microbiology Unit &#8211; Hospital de S&#227;o Jo&#227;o</span> Directora de Servi&#231;o&#58; Prof&#46; Doutora Maria Jos&#233; Vaz &#47; <span class="elsevierStyleItalic">Director&#58; Prof&#46; Doutora Maria Jos&#233; Vaz</span>"
            "etiqueta" => "3"
            "identificador" => "af0015"
          ]
          3 => array:3 [
            "entidad" => "Assistente Hospitalar Graduado de Imunoalergologia &#47; <span class="elsevierStyleItalic">Allergology and Clinical Immunology consultant&#44;</span> Servi&#231;o de Sa&#250;de Ocupacional &#8211; Hospital de S&#227;o Jo&#227;o &#47; <span class="elsevierStyleItalic">Occupational Health Unit &#8211; Hospital de S&#227;o Jo&#227;o</span> Director de Servi&#231;o&#58; Prof&#46; Doutor Jos&#233; Torres Costa &#47; <span class="elsevierStyleItalic">Director&#58; Prof&#46; Doutor Jos&#233; Torres Costa</span>"
            "etiqueta" => "4"
            "identificador" => "af0020"
          ]
          4 => array:3 [
            "entidad" => "Chefe de Servi&#231;o e Director de Servi&#231;o de Pneumologia &#47; <span class="elsevierStyleItalic">Head &#47;director&#44; Pulmonology Unit&#44;</span> Servi&#231;o de Pneumologia &#8211; Hospital de S&#227;o Jo&#227;o &#47; <span class="elsevierStyleItalic">Pulmonology Unit &#8211; Hospital de S&#227;o Jo&#227;o</span> Director de Servi&#231;o&#58; Prof&#46; Doutor Jos&#233; Agostinho Marques &#47; <span class="elsevierStyleItalic">Director&#58; Prof&#46; Doutor Jos&#233; Agostinho Marques</span>"
            "etiqueta" => "5"
            "identificador" => "af0025"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cr0005"
            "etiqueta" => "&#42;"
            "correspondencia" => "Hospital de S&#227;o Jo&#227;o &#8211; Alameda Prof&#46; Hern&#226;ni Monteiro&#44; 4202-451 Porto&#44; Telefone&#58; 225512215"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Tuberculosis in hospital department health care workers"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2006-10-16"
    "fechaAceptado" => "2007-06-01"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec570433"
          "palabras" => array:3 [
            0 => "Tuberculose"
            1 => "profissionais de sa&#250;de"
            2 => "nosocomial"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key-words"
          "identificador" => "xpalclavsec570434"
          "palabras" => array:3 [
            0 => "Tuberculosis"
            1 => "health care workers"
            2 => "nosocomial"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdu&#231;&#227;o&#58;</span> A tuberculose &#233; considerada uma doen&#231;a ocupacional nos profissionais de sa&#250;de e a sua transmiss&#227;o&#44; nas institui&#231;&#245;es de sa&#250;de&#44; constitui um problema importante&#46; Alguns servi&#231;os hospitalares est&#227;o particularmente expostos a risco de infec&#231;&#227;o&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Objectivo&#58;</span> Caracterizar os casos de tuberculose detectados na sequ&#234;ncia de um rastreio efectuado aos profissionais de sa&#250;de de um servi&#231;o hospitalar &#40;otorrinolaringologia&#41; que contactaram com casos de tuberculose activa&#46;</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Material e m&#233;todos&#58;</span> Procedeu-se &#224; realiza&#231;&#227;o de rastreio de tuberculose a todos os funcion&#225;rios &#40;73&#41; do servi&#231;o de Otorrinolaringologia do Hospital de S&#227;o Jo&#227;o que contactaram com dois doentes internados com tuberculose activa&#46; A todos aqueles que referiram sintomas foi realizada radiografia tor&#225;cica e exame micobacteriol&#243;gico de expectora&#231;&#227;o&#46;</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Resultados&#58;</span> Dos 73 profissionais de sa&#250;de submetidos ao rastreio&#44; foi estabelecido o diagn&#243;stico de tuberculose em 9 &#40;8 do sexo feminino&#59; idade mediana&#58; 30 anos&#59; uma m&#233;dica&#44; seis enfermeiros e dois auxiliares de ac&#231;&#227;o m&#233;dica&#41;&#46; Em 8 profissionais de sa&#250;de foi diagnosticada tuberculose pulmonar&#44; tratando-se o outro caso de tuberculose extra-pulmonar&#46; O diagn&#243;stico microbiol&#243;gico foi obtido em 7 casos pelos seguintes m&#233;todos&#58; exame micobacteriol&#243;gico directo de expectora&#231;&#227;o&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; exame cultural de lavado br&#244;nquico&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#59; exame histol&#243;gico de tecido pleural&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46; Em 4 casos&#44; o DNA do <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> foi extra&#237;do das culturas&#44; tendo sido efectuada tipagem molecular&#46; Todos estes casos apresentaram tipagem id&#234;ntica&#44; o que permite a identifica&#231;&#227;o de uma liga&#231;&#227;o epidemiol&#243;gica&#46;</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclus&#227;o&#58;</span> A tuberculose nosocomial &#233; relevante&#44; sendo necess&#225;rio efectuar um esfor&#231;o para implementar&#44; com sucesso&#44; medidas de controlo de infec&#231;&#227;o nas institui&#231;&#245;es de sa&#250;de&#44; assim como um programa eficaz de rastreio de tuberculose entre os profissionais de sa&#250;de&#46; A tipagem molecular do <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> facilita a identifica&#231;&#227;o de <span class="elsevierStyleItalic">clusters</span> de infec&#231;&#227;o&#46;</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007&#59; XIII &#40;6&#41;&#58; 789-799</span></p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introduction&#58;</span> Tuberculosis &#40;TB&#41; is considered an occupational disease in health care workers &#40;HCW&#41; and its transmission in health care facilities is an important concern&#46; Some hospital departments are at higher risk of infection&#46;</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Objective&#58;</span> To describe TB cases detected after TB screening in HCW from a hospital department &#40;Ear&#44; Nose and Throat &#8211; ENT&#41; who had had contact with active TB cases&#46;</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Material and methods&#58;</span> All HCW &#40;73&#41; from <span class="elsevierStyleItalic">Hospital S&#227;o Jo&#227;o</span>&#8217;s ENT Unit who had been in contact with two in-patients with active TB underwent TB screening&#46; Those who had symptoms underwent chest X-ray and mycobacteriological sputum exam&#46;</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Results&#58;</span> Of 73 HCW who underwent TB screening&#44; TB diagnosis was established in 9 &#40;8 female&#59; median age&#58; 30 years&#59; 1 doctor&#44; 6 nurses&#44; 2 nursing auxiliaries&#41;&#46; Pulmonary TB was found in 8 and extra-pulmonary TB in 1&#46; Microbiology diagnosis was obtained in 7 cases by sputum smear&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; culture exam in bronchial lavage&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4 and histological exam of pleural tissue&#44; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46; In 4 cases&#44; <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> genomic DNA was extracted from cultures and molecular typing was done&#46; All cases had identical MIRU types&#44; which allowed identification of the epidemiological link&#46;</p><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Conclusion&#58;</span> Nosocomial TB is prominent and efforts should be made to implement successful infection control measures in health care facilities and an effective TB screening program in HCW&#46; Molecular typing of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> facilitates cluster identification&#46;</p><p id="sp0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007&#59; XIII &#40;6&#41;&#58; 789-799</span></p></span>"
      ]
    ]
    "lecturaRecomendada" => array:1 [
      0 => array:3 [
        "vista" => "all"
        "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia &#47; Bibliography</span>"
        "seccion" => array:1 [
          0 => array:2 [
            "vista" => "all"
            "bibliografiaReferencia" => array:18 [
              0 => array:3 [
                "identificador" => "bb0005"
                "etiqueta" => "1&#46;"
                "referencia" => array:1 [
                  0 => array:1 [
                    "referenciaCompleta" => "Programa Nacional de Luta Contra a Tuberculose &#8211; Sistema de Vigil&#226;ncia &#40;SVIG-TB&#41;&#46; Ponto da situa&#231;&#227;o epidemiol&#243;gica e indicadores de desempenho&#46; Ano 2003 &#40;Relat&#243;rio definitivo&#41;&#46; Ano 2004 &#40;Relat&#243;rio preliminar&#41;&#46; Direc&#231;&#227;o Geral da Sa&#250;de&#46; Divis&#227;o de Doen&#231;as Transmiss&#237;veis&#46; Mar&#231;o de 2005&#46;"
                  ]
                ]
              ]
              1 => array:3 [
                "identificador" => "bb0010"
                "etiqueta" => "2&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Tuberculosis in health care personnel in a general hospital"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:9 [
                              0 => "X&#46; Casas"
                              1 => "J&#46; Ruiz-Manzano"
                              2 => "I&#46; Casas"
                              3 => "F&#46; Andreo"
                              4 => "J&#46; Sanz"
                              5 => "N&#46; Rodriguez"
                              6 => "A&#46; Marin"
                              7 => "C&#46; Prat"
                              8 => "M&#46; Esteve"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:6 [
                          "tituloSerie" => "Med Clin"
                          "fecha" => "2004"
                          "volumen" => "122"
                          "numero" => "19"
                          "paginaInicial" => "741"
                          "paginaFinal" => "743"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              2 => array:3 [
                "identificador" => "bb0015"
                "etiqueta" => "3&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Risk of tuberculosis among healthcare workers&#58; can tuberculosis be considered as an occupational disease&#63;"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:7 [
                              0 => "O&#46; Kilinc"
                              1 => "E&#46;S&#46; Ucan"
                              2 => "M&#46;D&#46; Cakan"
                              3 => "M&#46;D&#46; Ellidokuz"
                              4 => "M&#46;D&#46; Ozol"
                              5 => "A&#46; Sayiner"
                              6 => "M&#46;D&#46; Ozsoz"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Respir Med"
                          "fecha" => "2002"
                          "volumen" => "96"
                          "numero" => "7"
                          "paginaInicial" => "506"
                          "paginaFinal" => "510"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12194634"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              3 => array:3 [
                "identificador" => "bb0020"
                "etiqueta" => "4&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Increased risk of tuberculosis among health care workers in Samara Oblast&#44; Russia&#58; analysis of notification data"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:8 [
                              0 => "B&#46; Dimitrova"
                              1 => "A&#46; Hutchings"
                              2 => "R&#46; Atun"
                              3 => "F&#46; Drobniewski"
                              4 => "G&#46; Marchenko"
                              5 => "S&#46; Zakharova"
                              6 => "I&#46; Fedorin"
                              7 => "R&#46;J&#46; Coker"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Int J Tuberc Lung Dis"
                          "fecha" => "2005"
                          "volumen" => "9"
                          "numero" => "1"
                          "paginaInicial" => "43"
                          "paginaFinal" => "48"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15675549"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              4 => array:3 [
                "identificador" => "bb0025"
                "etiqueta" => "5&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Occupational risk of tuberculosis among health care workers at the Institute for Pulmonary Diseases of Serbia"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:8 [
                              0 => "V&#46; Skodric"
                              1 => "B&#46; Savic"
                              2 => "M&#46; Jovanovic"
                              3 => "I&#46; Pesic"
                              4 => "J&#46; Videnovic"
                              5 => "V&#46; Zugic"
                              6 => "J&#46; Rakovic"
                              7 => "M&#46; Stojkovic"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Int J Tuberc Lung Dis"
                          "fecha" => "2000"
                          "volumen" => "4"
                          "numero" => "9"
                          "paginaInicial" => "827"
                          "paginaFinal" => "831"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10985650"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              5 => array:3 [
                "identificador" => "bb0030"
                "etiqueta" => "6&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "CDC"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:4 [
                          "tituloSerie" => "MMWR"
                          "fecha" => "1994"
                          "volumen" => "43"
                          "paginaInicial" => "RR-13"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              6 => array:3 [
                "identificador" => "bb0035"
                "etiqueta" => "7&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Tuberculosis among health care workers in a short working period"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "S&#46; Hosoglu"
                              1 => "A&#46;C&#46; Tanrikulu"
                              2 => "C&#46; Dagli"
                              3 => "S&#46; Akalin"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1016/j.ajic.2004.07.013"
                        "Revista" => array:7 [
                          "tituloSerie" => "Am J Infect Control"
                          "fecha" => "2005"
                          "volumen" => "33"
                          "numero" => "1"
                          "paginaInicial" => "23"
                          "paginaFinal" => "26"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15685131"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              7 => array:3 [
                "identificador" => "bb0040"
                "etiqueta" => "8&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Tuberculosis among health care workers at King Chulalongkorn Memorial Hospital&#44; 1988-2002"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:3 [
                              0 => "W&#46; Jiamjarasrangsi"
                              1 => "N&#46; Hirunsuthikul"
                              2 => "P&#46; Kamolratanakul"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Int J Tuberc Lung Dis"
                          "fecha" => "2005"
                          "volumen" => "9"
                          "numero" => "11"
                          "paginaInicial" => "1253"
                          "paginaFinal" => "1258"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16333934"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              8 => array:3 [
                "identificador" => "bb0045"
                "etiqueta" => "9&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Tuberculosis in health care workers in a central hospital in Malawi"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "H&#46;S&#46; Kanyerere"
                              1 => "F&#46;M&#46; Salaniponi"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Int J Tuberc Lung Dis"
                          "fecha" => "2003"
                          "volumen" => "7"
                          "numero" => "5"
                          "paginaInicial" => "489"
                          "paginaFinal" => "492"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12757052"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              9 => array:3 [
                "identificador" => "bb0050"
                "etiqueta" => "10&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Risk of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> infection and disease among health care workers&#44; Chiang Rai&#44; Thailand"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:6 [
                              0 => "H&#46; Yanai"
                              1 => "K&#46; Limpakarnjanarat"
                              2 => "W&#46; Uthaivoravit"
                              3 => "T&#46;D&#46; Mastro"
                              4 => "T&#46; Mori"
                              5 => "J&#46;W&#46; Tappero"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Int J Tuberc Lung Dis"
                          "fecha" => "2003"
                          "volumen" => "7"
                          "numero" => "1"
                          "paginaInicial" => "36"
                          "paginaFinal" => "45"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12701833"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              10 => array:3 [
                "identificador" => "bb0055"
                "etiqueta" => "11&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Increased risk of tuberculosis in health care workers&#58; a retrospective survey at a teaching hospital in Istanbul&#44; Turkey"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:4 [
                              0 => "C&#46; Cuhadaroglu"
                              1 => "M&#46; Erelel"
                              2 => "L&#46; Tabak"
                              3 => "Z&#46; Kilicaslan"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:5 [
                          "tituloSerie" => "BMC Infect Dis"
                          "fecha" => "2002"
                          "volumen" => "26"
                          "numero" => "2"
                          "paginaInicial" => "14"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              11 => array:3 [
                "identificador" => "bb0060"
                "etiqueta" => "12&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Guidelines for preventing the transmission of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> in health-care settings&#44; 2005"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:5 [
                              0 => "CDC"
                              1 => "P&#46;A&#46; Jensen"
                              2 => "L&#46;A&#46; Lambert"
                              3 => "M&#46;F&#46; Iademarco"
                              4 => "R&#46; Ridzon"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "MMWR Recomm Rep"
                          "fecha" => "2005"
                          "volumen" => "54"
                          "numero" => "17"
                          "paginaInicial" => "1"
                          "paginaFinal" => "141"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16382216"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              12 => array:3 [
                "identificador" => "bb0065"
                "etiqueta" => "13&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Mycobacterial Interspersed Repetitive Unit Typing of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> Compared to IS6110-Based Restriction Fragment Length Polymorphism Analysis for Investigation of Apparently Clustered Cases of Tuberculosis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:8 [
                              0 => "P&#46;M&#46; Hawkey"
                              1 => "E&#46;G&#46; Smith"
                              2 => "J&#46;T&#46; Evans"
                              3 => "P&#46; Monk"
                              4 => "G&#46; Bryan"
                              5 => "H&#46;H&#46; Mohamed"
                              6 => "M&#46; Bardhan"
                              7 => "R&#46;N&#46; Pugh"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "J Clin Microbiol"
                          "fecha" => "2003"
                          "volumen" => "41"
                          "numero" => "8"
                          "paginaInicial" => "3514"
                          "paginaFinal" => "3520"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12904348"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              13 => array:3 [
                "identificador" => "bb0070"
                "etiqueta" => "14&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Molecular typing of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> by Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeat Analysis&#44; a More Accurate Method for Identifying Epidemiological Links between Patients with Tuberculosis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:8 [
                              0 => "H&#46; Van Deutekom"
                              1 => "P&#46; Supply"
                              2 => "P&#46;E&#46;W&#46; De Haas"
                              3 => "E&#46; Willery"
                              4 => "S&#46;P&#46; Hoijng"
                              5 => "C&#46; Locht"
                              6 => "R&#46;A&#46; Coutinho"
                              7 => "D&#46; Van Soolingen"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1128/JCM.43.9.4473-4479.2005"
                        "Revista" => array:6 [
                          "tituloSerie" => "J Clin Microbiol"
                          "fecha" => "2005"
                          "volumen" => "43"
                          "paginaInicial" => "4473"
                          "paginaFinal" => "4479"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16145094"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              14 => array:3 [
                "identificador" => "bb0075"
                "etiqueta" => "15&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Sensitivities and Specificities of Spoligotyping and Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeat Typing Methods for Studying Molecular Epidemiology of Tuberculosis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:8 [
                              0 => "A&#46;N&#46; Scott"
                              1 => "D&#46; Menzies"
                              2 => "T&#46;N&#46; Tannenbaum"
                              3 => "L&#46; Thibert"
                              4 => "R&#46; Kozak"
                              5 => "L&#46; Joseph"
                              6 => "K&#46; Schwartzman"
                              7 => "M&#46;A&#46; Behr"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1128/JCM.43.1.89-94.2005"
                        "Revista" => array:6 [
                          "tituloSerie" => "J Clin Microbiol"
                          "fecha" => "2005"
                          "volumen" => "43"
                          "paginaInicial" => "89"
                          "paginaFinal" => "94"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15634955"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              15 => array:3 [
                "identificador" => "bb0080"
                "etiqueta" => "16&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Molecular Epidemiology of Tuberculosis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:2 [
                              0 => "P&#46;F&#46; Barnes"
                              1 => "M&#46;D&#46; Cave"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:2 [
                        "doi" => "10.1056/NEJMra021964"
                        "Revista" => array:6 [
                          "tituloSerie" => "N Engl J Med"
                          "fecha" => "2003"
                          "volumen" => "349"
                          "paginaInicial" => "1149"
                          "paginaFinal" => "1156"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13679530"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              16 => array:3 [
                "identificador" => "bb0085"
                "etiqueta" => "17&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Outbreak of multiple drug-resistant tuberculosis in Lisbon&#58; detection by restriction fragment length polymorphism analysis"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:7 [
                              0 => "I&#46; Portugal"
                              1 => "M&#46;J&#46; Covas"
                              2 => "L&#46; Brum"
                              3 => "M&#46; Viveiros"
                              4 => "P&#46; Ferrinho"
                              5 => "J&#46; Moniz-Pereira"
                              6 => "H&#46; David"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "Int J Tuberc Lung Dis"
                          "fecha" => "1999"
                          "volumen" => "3"
                          "numero" => "3"
                          "paginaInicial" => "207"
                          "paginaFinal" => "213"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10094321"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
              17 => array:3 [
                "identificador" => "bb0090"
                "etiqueta" => "18&#46;"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [
                      0 => array:2 [
                        "titulo" => "Nosocomial transmission of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> found through screening for severe acute respiratory syndrome &#8211; Taipei&#44; Taiwan&#44; 2003"
                        "autores" => array:1 [
                          0 => array:2 [
                            "etal" => false
                            "autores" => array:1 [
                              0 => "CDC"
                            ]
                          ]
                        ]
                      ]
                    ]
                    "host" => array:1 [
                      0 => array:1 [
                        "Revista" => array:7 [
                          "tituloSerie" => "MMWR"
                          "fecha" => "2004"
                          "volumen" => "53"
                          "numero" => "15"
                          "paginaInicial" => "321"
                          "paginaFinal" => "322"
                          "link" => array:1 [
                            0 => array:2 [
                              "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15103296"
                              "web" => "Medline"
                            ]
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/08732159/0000001300000006/v1_201509151528/S0873215915303767/v1_201509151528/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9575"
    "tipo" => "SECCION"
    "pt" => array:2 [
      "titulo" => "Artigos originais"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "pt"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001300000006/v1_201509151528/S0873215915303767/v1_201509151528/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915303767?idApp=UINPBA00004E"
]
Share
Journal Information
Vol. 13. Issue 6.
Pages 789-799 (November - December 2007)
Share
Share
Download PDF
More article options
Vol. 13. Issue 6.
Pages 789-799 (November - December 2007)
Artigo Original / Original Article
Open Access
Tuberculose em profissionais de saúde de um serviço hospitalar
Tuberculosis in hospital department health care workers
Visits
5755
Sandra Saleiro1,
Corresponding author
sandrasaleiro@portugalmail.pt

Hospital de São João – Alameda Prof. Hernâni Monteiro, 4202-451 Porto, Telefone: 225512215
, Ana Rosa Santos2, Otília Vidal2, Teresa Carvalho3, José Torres Costa4, José Agostinho Marques5
1 Interna Complementar de Pneumologia / Pulmonology resident, Serviço de Pneumologia – Hospital de São João / Pulmonology Unit – Hospital de São João Director de Serviço: Prof. Doutor José Agostinho Marques / Director: Prof. Doutor José Agostinho Marques
2 Assistente Hospitalar Graduada de Pneumologia / Pulmonology consultant, Serviço de Pneumologia – Hospital de São João / Pulmonology Unit – Hospital de São João Director de Serviço: Prof. Doutor José Agostinho Marques / Director: Prof. Doutor José Agostinho Marques
3 Assessora Superior de Saúde; Licenciada em Farmácia / Senior health care assistant; Pharmacy graduate, Serviço de Microbiologia – Hospital de São João / Microbiology Unit – Hospital de São João Directora de Serviço: Prof. Doutora Maria José Vaz / Director: Prof. Doutora Maria José Vaz
4 Assistente Hospitalar Graduado de Imunoalergologia / Allergology and Clinical Immunology consultant, Serviço de Saúde Ocupacional – Hospital de São João / Occupational Health Unit – Hospital de São João Director de Serviço: Prof. Doutor José Torres Costa / Director: Prof. Doutor José Torres Costa
5 Chefe de Serviço e Director de Serviço de Pneumologia / Head /director, Pulmonology Unit, Serviço de Pneumologia – Hospital de São João / Pulmonology Unit – Hospital de São João Director de Serviço: Prof. Doutor José Agostinho Marques / Director: Prof. Doutor José Agostinho Marques
This item has received

Under a Creative Commons license
Article information
Resumo

Introdução: A tuberculose é considerada uma doença ocupacional nos profissionais de saúde e a sua transmissão, nas instituições de saúde, constitui um problema importante. Alguns serviços hospitalares estão particularmente expostos a risco de infecção.

Objectivo: Caracterizar os casos de tuberculose detectados na sequência de um rastreio efectuado aos profissionais de saúde de um serviço hospitalar (otorrinolaringologia) que contactaram com casos de tuberculose activa.

Material e métodos: Procedeu-se à realização de rastreio de tuberculose a todos os funcionários (73) do serviço de Otorrinolaringologia do Hospital de São João que contactaram com dois doentes internados com tuberculose activa. A todos aqueles que referiram sintomas foi realizada radiografia torácica e exame micobacteriológico de expectoração.

Resultados: Dos 73 profissionais de saúde submetidos ao rastreio, foi estabelecido o diagnóstico de tuberculose em 9 (8 do sexo feminino; idade mediana: 30 anos; uma médica, seis enfermeiros e dois auxiliares de acção médica). Em 8 profissionais de saúde foi diagnosticada tuberculose pulmonar, tratando-se o outro caso de tuberculose extra-pulmonar. O diagnóstico microbiológico foi obtido em 7 casos pelos seguintes métodos: exame micobacteriológico directo de expectoração, n=2; exame cultural de lavado brônquico, n=4; exame histológico de tecido pleural, n=1. Em 4 casos, o DNA do Mycobacterium tuberculosis foi extraído das culturas, tendo sido efectuada tipagem molecular. Todos estes casos apresentaram tipagem idêntica, o que permite a identificação de uma ligação epidemiológica.

Conclusão: A tuberculose nosocomial é relevante, sendo necessário efectuar um esforço para implementar, com sucesso, medidas de controlo de infecção nas instituições de saúde, assim como um programa eficaz de rastreio de tuberculose entre os profissionais de saúde. A tipagem molecular do Mycobacterium tuberculosis facilita a identificação de clusters de infecção.

Rev Port Pneumol 2007; XIII (6): 789-799

Palavras-chave:
Tuberculose
profissionais de saúde
nosocomial
Abstract

Introduction: Tuberculosis (TB) is considered an occupational disease in health care workers (HCW) and its transmission in health care facilities is an important concern. Some hospital departments are at higher risk of infection.

Objective: To describe TB cases detected after TB screening in HCW from a hospital department (Ear, Nose and Throat – ENT) who had had contact with active TB cases.

Material and methods: All HCW (73) from Hospital São João’s ENT Unit who had been in contact with two in-patients with active TB underwent TB screening. Those who had symptoms underwent chest X-ray and mycobacteriological sputum exam.

Results: Of 73 HCW who underwent TB screening, TB diagnosis was established in 9 (8 female; median age: 30 years; 1 doctor, 6 nurses, 2 nursing auxiliaries). Pulmonary TB was found in 8 and extra-pulmonary TB in 1. Microbiology diagnosis was obtained in 7 cases by sputum smear, n=2; culture exam in bronchial lavage, n=4 and histological exam of pleural tissue, n=1. In 4 cases, Mycobacterium tuberculosis genomic DNA was extracted from cultures and molecular typing was done. All cases had identical MIRU types, which allowed identification of the epidemiological link.

Conclusion: Nosocomial TB is prominent and efforts should be made to implement successful infection control measures in health care facilities and an effective TB screening program in HCW. Molecular typing of Mycobacterium tuberculosis facilitates cluster identification.

Rev Port Pneumol 2007; XIII (6): 789-799

Key-words:
Tuberculosis
health care workers
nosocomial
Full text is only aviable in PDF
Bibliografia / Bibliography
[1.]
Programa Nacional de Luta Contra a Tuberculose – Sistema de Vigilância (SVIG-TB). Ponto da situação epidemiológica e indicadores de desempenho. Ano 2003 (Relatório definitivo). Ano 2004 (Relatório preliminar). Direcção Geral da Saúde. Divisão de Doenças Transmissíveis. Março de 2005.
[2.]
X. Casas, J. Ruiz-Manzano, I. Casas, F. Andreo, J. Sanz, N. Rodriguez, A. Marin, C. Prat, M. Esteve.
Tuberculosis in health care personnel in a general hospital.
Med Clin, 122 (2004), pp. 741-743
[3.]
O. Kilinc, E.S. Ucan, M.D. Cakan, M.D. Ellidokuz, M.D. Ozol, A. Sayiner, M.D. Ozsoz.
Risk of tuberculosis among healthcare workers: can tuberculosis be considered as an occupational disease?.
Respir Med, 96 (2002), pp. 506-510
[4.]
B. Dimitrova, A. Hutchings, R. Atun, F. Drobniewski, G. Marchenko, S. Zakharova, I. Fedorin, R.J. Coker.
Increased risk of tuberculosis among health care workers in Samara Oblast, Russia: analysis of notification data.
Int J Tuberc Lung Dis, 9 (2005), pp. 43-48
[5.]
V. Skodric, B. Savic, M. Jovanovic, I. Pesic, J. Videnovic, V. Zugic, J. Rakovic, M. Stojkovic.
Occupational risk of tuberculosis among health care workers at the Institute for Pulmonary Diseases of Serbia.
Int J Tuberc Lung Dis, 4 (2000), pp. 827-831
[6.]
CDC.
Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities.
MMWR, 43 (1994), pp. RR-13
[7.]
S. Hosoglu, A.C. Tanrikulu, C. Dagli, S. Akalin.
Tuberculosis among health care workers in a short working period.
Am J Infect Control, 33 (2005), pp. 23-26
[8.]
W. Jiamjarasrangsi, N. Hirunsuthikul, P. Kamolratanakul.
Tuberculosis among health care workers at King Chulalongkorn Memorial Hospital, 1988-2002.
Int J Tuberc Lung Dis, 9 (2005), pp. 1253-1258
[9.]
H.S. Kanyerere, F.M. Salaniponi.
Tuberculosis in health care workers in a central hospital in Malawi.
Int J Tuberc Lung Dis, 7 (2003), pp. 489-492
[10.]
H. Yanai, K. Limpakarnjanarat, W. Uthaivoravit, T.D. Mastro, T. Mori, J.W. Tappero.
Risk of Mycobacterium tuberculosis infection and disease among health care workers, Chiang Rai, Thailand.
Int J Tuberc Lung Dis, 7 (2003), pp. 36-45
[11.]
C. Cuhadaroglu, M. Erelel, L. Tabak, Z. Kilicaslan.
Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey.
BMC Infect Dis, 26 (2002), pp. 14
[12.]
CDC, P.A. Jensen, L.A. Lambert, M.F. Iademarco, R. Ridzon.
Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005.
MMWR Recomm Rep, 54 (2005), pp. 1-141
[13.]
P.M. Hawkey, E.G. Smith, J.T. Evans, P. Monk, G. Bryan, H.H. Mohamed, M. Bardhan, R.N. Pugh.
Mycobacterial Interspersed Repetitive Unit Typing of Mycobacterium tuberculosis Compared to IS6110-Based Restriction Fragment Length Polymorphism Analysis for Investigation of Apparently Clustered Cases of Tuberculosis.
J Clin Microbiol, 41 (2003), pp. 3514-3520
[14.]
H. Van Deutekom, P. Supply, P.E.W. De Haas, E. Willery, S.P. Hoijng, C. Locht, R.A. Coutinho, D. Van Soolingen.
Molecular typing of Mycobacterium tuberculosis by Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeat Analysis, a More Accurate Method for Identifying Epidemiological Links between Patients with Tuberculosis.
J Clin Microbiol, 43 (2005), pp. 4473-4479
[15.]
A.N. Scott, D. Menzies, T.N. Tannenbaum, L. Thibert, R. Kozak, L. Joseph, K. Schwartzman, M.A. Behr.
Sensitivities and Specificities of Spoligotyping and Mycobacterial Interspersed Repetitive Unit-Variable-Number Tandem Repeat Typing Methods for Studying Molecular Epidemiology of Tuberculosis.
J Clin Microbiol, 43 (2005), pp. 89-94
[16.]
P.F. Barnes, M.D. Cave.
Molecular Epidemiology of Tuberculosis.
N Engl J Med, 349 (2003), pp. 1149-1156
[17.]
I. Portugal, M.J. Covas, L. Brum, M. Viveiros, P. Ferrinho, J. Moniz-Pereira, H. David.
Outbreak of multiple drug-resistant tuberculosis in Lisbon: detection by restriction fragment length polymorphism analysis.
Int J Tuberc Lung Dis, 3 (1999), pp. 207-213
[18.]
CDC.
Nosocomial transmission of Mycobacterium tuberculosis found through screening for severe acute respiratory syndrome – Taipei, Taiwan, 2003.
MMWR, 53 (2004), pp. 321-322
Copyright © 2007. Sociedade Portuguesa de Pneumologia/SPP
Download PDF
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?