Post-exposure rate of tuberculosis infection among health care workers measured with tuberculin skin test conversion after unprotected exposure to patients with pulmonary tuberculosis: 6-year experience in an Italian teaching hospital.

BMC Infect Dis 2014 Jun 12;14:324. Epub 2014 Jun 12.

Direzione Medica di Presidio, Fondazione IRCCS Policlinico San Matteo, viale Camillo Golgi 19, Pavia 27100, Italy.

Background: This study assesses the risk of LTBI at our Hospital among HCWs who have been exposed to TB patients with a delayed diagnosis and respiratory protection measures were not implemented.

Methods: All HCWs exposed to a patient with cultural confirmed pulmonary TB and respiratory protection measures were not implemented were included. Data on TST results performed in the past (defined as T0) were recorded. TST was performed twice: first, immediately after exposure to an index patient (T1) and three months later (T2). The period of time between T0 and T1 was used to calculate he annual rate of tuberculosis infection (ARTI), while le period of time between T1 and T2 was used to calculate the post exposure annual rate of tuberculosis infection (PEARTI).

Results: Fourteen index patients were admitted; sputum smear was positive in 7 (58.3%), 4 (28.6%) were non-Italian born patients. 388 HCWs were exposed to index patients, a median of 27 (12-39) HCW per each index patient. One hundred eighty (46.4%) HCWs received BCG in the past. One hundred twenty two HCWs (31%) were TST positive at a previous routine screening and not evaluated in this subset. Among the remaining 255 HCWs with negative TST test in the past, TST at T1 was positive in 11 (4.3%). ARTI was 1.6 (95% CI 0.9-2.9) per 100 PY. TST at T2 was positive in 9 (3.7%) HCWs, that were TST negative at T1. PEARTI was 26 (95% CI 13.6-50) per 100 PY. At univariate analysis, older age was associated with post exposure latent tuberculosis infection (HR 1.12; 95% CI 1.03-1.22, p=0.01).

Conclusions: PEARTI was considerably higher among HCWs exposed to index patients than ARTI. These data underscore the overwhelming importance of performing a rapid diagnosis, as well as implementing adequate respiratory protection measures when TB is suspected.

Download full-text PDF

Source
http://dx.doi.org/10.1186/1471-2334-14-324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065580PMC
June 2014
12 Reads

Publication Analysis

Top Keywords

hcws exposed
16
tuberculosis infection
16
tst positive
12
rate tuberculosis
12
protection measures
12
respiratory protection
12
exposed patients
12
post exposure
8
annual rate
8
time calculate
8
period time
8
hcws
8
tst performed
8
tst
7
patients
6
tuberculosis
5
hcws 31%
4
exposure annual
4
31% tst
4
infection peartiresults
4

References

(Supplied by CrossRef)

RL Riley et al.
Am J Epidemiol 1995

I Baussano et al.
Emerg Infect Dis 2011

R Diel et al.
Respir Res 2005

D Menzies et al.
N Engl J Med 1995

NO Atuk et al.
JAMA 1971

RB Craven et al.
Ann Intern Med 1975

H Yanai et al.
Int J Tuberc Lung Dis 2003

TA Kenyon et al.
N Engl J Med 1996

HM Blumberg et al.
Clin Infect Dis 1998

KA Adal et al.
N Engl J Med 1994

D Menzies et al.
Int J Tuberc Lung Dis 2007

Similar Publications