OHW 88 - A Location- based Risk Assessment for Tuberculosis at a Multi-site Pediatric Facility

Background: Infection Prevention & Control completes an annual risk assessment for introduction and spread of Tuberculosis (TB) to guide occupational control efforts. The current Centers for Disease Control and Prevention (CDC) recommendations, however, do not account for facilities with satellite locations which may serve populations with different exposure risk factors. Using the International Statistical Classification of Diseases (ICD-10) diagnostic codes, we developed and implemented a surveillance system which stratified patients by campus location, service, and TB status to perform a multi-site TB risk assessment.

Methods: We utilized the ICD-10 codes documented in the electronic medical record (EMR) to identify patients with TB-related diagnoses January 1-December 31, 2021. Patients were categorized as suspected, latent, or active as per CDC definitions. All encounters in 2021 were collected and categorized for identified patients based on the highest risk category. Data was supplemented with a manual tracking list of patients with active TB and TB risk group categorization was manually reviewed.

Results: Overall, 376 patients were identified in 2021 with a TB diagnosis (active 2, latent 48, suspected 326). Fifty-five percent (207) were seen at least once at the main inpatient medical facility and 22% (83) were seen at the suburban inpatient facility. Patients were seen across 14 different satellite locations. Services most likely to provide care for a patient with latent TB by count include: Infectious Diseases (19), Radiology (15), Laboratory (11), and Rheumatology (5). We determined that the risk for occupational TB transmission was low across all our sites.

Conclusions: Assessing ICD-10 diagnostic codes can be used as a supplemental surveillance method to quantify risk for uncontrolled TB introduction for active, latent, and suspected TB. Although there are inherent limitations, utilizing this data may allow for a more comprehensive assessment of TB exposure risk and mitigate potential risk factors to healthcare personnel.