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conferenceseries
.com
Volume 7, Issue 3 (Suppl)
J Gastrointest Dig Syst, an open access journal
ISSN: 2161-069X
Gastro 2017
June 12-13, 2017
June 12-13, 2017 Rome, Italy
11
th
Global
GastroenterologistsMeeting
Comparison of the performance of LTBI screening to the BTS standards
Shuaib Meghji
University Hospital Southampton, UK
Background
: Patients with severe Inflammatory Bowel Disease (IBD) are prescribed anti-TNF-α agents, if clinical need necessitates,
whose immunosuppressive action can potentially reactivate latent tuberculosis infections (LTBI). Meticulous pre anti-TNF-α LTBI
screening and management in accordance with the British Thoracic Society’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’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’s biologics database. Inclusion criteria included
patients who started their first anti-TNF-α 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’ (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.
shuaibmeghji94@gmail.comShuaib Meghji, J Gastrointest Dig Syst 2017, 7:3(Suppl)
DOI: 10.4172/2161-069X-C1-049