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Serial Testing of Healthcare Workers for Latent Tuberculosis Infection and Long-Term Follow Up for Development of Active Tuberculosis
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A5381 - Serial Testing of Healthcare Workers for Latent Tuberculosis Infection and Long-Term Follow Up for Development of Active Tuberculosis
Author Block: Y. Kang1, Y. Park1, J. Kim2, M. Park1; 1Yonsei university College of Medicine, Seoul, Korea, Republic of, 2Yonsei university College of Medicine, seoul, Korea, Republic of.
BackgroundHealthcare workers (HCWs) are at high risk of tuberculosis (TB) infection due to occupational exposure.
Objective To analyze the rate of tuberculin skin test (TST) conversion at annual latent TB infection (LTBI) screenings and to assess the incidence of active TB after LTBI screening among HCWs at high risk of TB exposure. Design A retrospective cohort study involving HCWs at high risk of TB exposure Setting A tertiary care university hospital in South Korea Methods 458 HCWs were annually screened for LTBI between October 2009 and January 2013. All HCWs underwent a TST and chest X‑ray, and an interferon-γ release assay (IGRA) was performed in TST-converted subjects. Results The TST conversion rate was 30.3% from 2009 to 2011, 7.4% from 2011 to 2012, and 17.4% from 2012 to 2013. Only 26% of TST converters showed positive IGRA results. Two cases of active TB developed during the follow-up period among TST-converted and IGRA-positive subjects. One of them was treated with isoniazid and rifampicin for 3 months for LTBI after TST conversion. At 31 months after completion of LTBI treatment, active TB developed, and the isolated M. tuberculosis was resistant to isoniazid, ethambutol, and streptomycin. The other nurse was diagnosed with active pulmonary TB at 38 months after TST conversion. Conclusions The rate of TST conversion in HCWs at high risk of TB exposure sampled from a tertiary referral hospital in a country with an intermediate burden of TB was considerable. However, the proportion of TST-converted HCWs with positive IGRA results was low, and active TB developed only in TST‑converted IGRA-positive HCWs. Therefore, combined use of the TST and IGRA for periodic monitoring of new TB infections in HCWs may be effective in areas with an intermediate TB burden in which Bacillus Calmette-Guerin vaccination is mandatory.
Author Block: Y. Kang1, Y. Park1, J. Kim2, M. Park1; 1Yonsei university College of Medicine, Seoul, Korea, Republic of, 2Yonsei university College of Medicine, seoul, Korea, Republic of.
BackgroundHealthcare workers (HCWs) are at high risk of tuberculosis (TB) infection due to occupational exposure.
Objective To analyze the rate of tuberculin skin test (TST) conversion at annual latent TB infection (LTBI) screenings and to assess the incidence of active TB after LTBI screening among HCWs at high risk of TB exposure. Design A retrospective cohort study involving HCWs at high risk of TB exposure Setting A tertiary care university hospital in South Korea Methods 458 HCWs were annually screened for LTBI between October 2009 and January 2013. All HCWs underwent a TST and chest X‑ray, and an interferon-γ release assay (IGRA) was performed in TST-converted subjects. Results The TST conversion rate was 30.3% from 2009 to 2011, 7.4% from 2011 to 2012, and 17.4% from 2012 to 2013. Only 26% of TST converters showed positive IGRA results. Two cases of active TB developed during the follow-up period among TST-converted and IGRA-positive subjects. One of them was treated with isoniazid and rifampicin for 3 months for LTBI after TST conversion. At 31 months after completion of LTBI treatment, active TB developed, and the isolated M. tuberculosis was resistant to isoniazid, ethambutol, and streptomycin. The other nurse was diagnosed with active pulmonary TB at 38 months after TST conversion. Conclusions The rate of TST conversion in HCWs at high risk of TB exposure sampled from a tertiary referral hospital in a country with an intermediate burden of TB was considerable. However, the proportion of TST-converted HCWs with positive IGRA results was low, and active TB developed only in TST‑converted IGRA-positive HCWs. Therefore, combined use of the TST and IGRA for periodic monitoring of new TB infections in HCWs may be effective in areas with an intermediate TB burden in which Bacillus Calmette-Guerin vaccination is mandatory.
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