table 1. Continued


Author (Year Published)


Study Location and Design


Moran (2008)40 11 urban US cities; prospective cohort (derivation and validation); patients admitted with diagnosis of pneumonia or suspected TB


Rakoczy (2008)41


Sacramento, case-control (derivation) and retrospective cohort


(validation); patients admitted to respiratory isolation and patients diagnosed with TB


Aguilar (2009)42 Detroit, case-control; cases included all patients with a respiratory tract culture positive for TB, and controls included patients admitted to respiratory isolation


African-American race (1); history of active TB (2); history of positive TST (1); history of TB exposure (2); AIDS (


− 2) TB Risk Factors


Immigrant, homeless, TB history, incarceration history


Clinical Symptoms or Signs


Weight loss


Radiographic or Laboratory Findings


Apical infiltrate, cavity on CXR


Sensitivity %, Specificity %


96, 49 (valid)


PPV %, NPV %, Comment 8, 99 (valid)


Positive≥1 point


Immunosuppressed condition other than HIVb (4), foreign-born (2)


Weight loss, fevers, malaise, or night sweats for >2 weeks (6), Shortness of breath (


− 2)


Upper zone findings on CXR (2)


97, 42 (valid)


18, 99 (valid)


Positive≥4 points


Weight loss >10% body weight in past 2 weeks (3); Night sweats for >2 weeks (3); Malaise for >1 month (3); Sputum production >2 weeks (1):


Upper lobe cavity or consolidation on CXRc (4); upper lobe cavity or consolidation on CTd (3) Positive TST while hospitalized (4); WBC count 4,000– 10,000 cells/mm3 (2); WBC >10,000 cells/mm3 (


− 2)


NOTE. All clinical prediction rules identify patients at high and low risk for pulmonary TB. AIDS, acquired immunodeficiency syndrome; CT, computed tomography; CXR, chest radiograph; °C, degrees in Celsius; HIV, human immunodeficiency virus; IBW, ideal body weight; IDU, injection drug user; INH, isoniazid; NPV, negative predictive value; PPV, positive predictive value; Sens, sensitivity; Spec: specificity; Temp, temperature; TST, tuberculin skin test;


TB, tuberculosis; US, United States; Valid, validation; WBC, white blood cell count. aClinical prediction rules assign 1 point to each criterion; for prediction rules that assign different points to criteria, the point value is noted in parentheses. bImmunosuppressed conditions other than HIV infection were defined as chronic liver disease, chronic kidney disease, diabetes mellitus, active cancer of any type, receipt of any steroid or


other immunosuppressive drug in the past 3 months, and alcoholism. cAll case and control patients had a CXR. dOnly 55% of case patients and 49% of control patients had a CT scan.


99, 34 (all patients) 80, 63 (patients with CT scans)


3, 99 (all patients) 4, 99 (patients with CT scans)


Positive≥4 points


1218 infection control & hospital epidemiology october 2015, vol. 36, no. 10


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