ISSN: 2161-069X
Journal of Gastrointestinal & Digestive System
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Comparison of the performance of LTBI screening to the BTS standards
11th Global Gastroenterologists Meeting
Shuaib Meghji
University Hospital Southampton, UK
ScientificTracks Abstracts: J Gastrointest Dig Syst
DOI:
Abstract
Background: Patients with severe Inflammatory Bowel Disease (IBD) are prescribed anti-TNF-�?卤 agents, if clinical need necessitates, whose immunosuppressive action can potentially reactivate latent tuberculosis infections (LTBI). Meticulous pre anti-TNF-�?卤 LTBI screening and management in accordance with the British Thoracic Society芒�?�?s (BTS) Guidelines is imperative for patient safety and public health. Objective: A retrospective clinical audit was performed to evaluate the performance of University Hospital Southampton芒�?�?s Gastroenterology department in screening for LTBI in patients with IBD. The performance of LTBI screening was compared to the BTS standards. Method: The audit population was obtained using the gastroenterology department芒�?�?s biologics database. Inclusion criteria included patients who started their first anti-TNF-�?卤 agent between 01/01/2006 to 04/11/2016. Exclusion criteria included deceased patients and patients screened by alternative departments/trusts. Extent of LTBI screening was assessed using hospital record systems: EDocs, EQuest, ECamis and Spectra PACS. If evidence of screening was not located, then this was considered as a failure to meet standard. Following statistical analysis, comparisons were made with BTS standards. Results: Of the 471 patients audited, 51.2% were females and 48.8% males. 75.2% were CD patients and 24.8% were UC patients. 231 patients芒�?�? (49%) LTBI screening was insufficient. 157 patients (33.3%) lacked an adequate TB history and 94 patients (20%) failed to have a chest radiograph (CXR) within three months of therapy commencement. Additionally, 85 patients (18.3%) failed to have an IGRA performed. 15 patients (3.2%) were diagnosed with LTBI, while one case of TB reactivation occurred once immunosuppressive therapy had commenced. Conclusion: The completeness of LTBI screening in the audited group was suboptimal with deficits in TB history performance, CXR, TST and IGRAs. One case of active miliary TB occurred as a result of inadequate screening. In light of this, recommendations to address deficits and ultimately improve screening were proposed.Biography
Shuaib Meghji is currently studying at University Hospital Southampton, UK.
Email: shuaibmeghji94@gmail.com
