The Importance of Two-Step Tuberculin Skin Testing for Newly Employed Healthcare Workers

2006 ◽  
Vol 27 (5) ◽  
pp. 512-514 ◽  
Author(s):  
Elizabeth C. Frenzel ◽  
Georgia A. Thomas ◽  
Hend A. Hanna

At the time of hire, 4059 of 6522 healthcare workers required a 2-step tuberculin skin test; 114 workers (2.8%) demonstrated a boosted reaction after the second step. Boosted reactions were significantly associated with male sex and older age. A verbal history of previous tuberculin skin test results was not a reliable indicator of baseline tuberculin skin test status at the time of hire.

Renal Failure ◽  
2005 ◽  
Vol 27 (4) ◽  
pp. 425-428 ◽  
Author(s):  
Ekrem Dogan ◽  
Reha Erkoc ◽  
Hayriye Sayarlioglu ◽  
Kursat Uzun

Renal Failure ◽  
2005 ◽  
Vol 27 (4) ◽  
pp. 425-428 ◽  
Author(s):  
Ekrem Dogan ◽  
Reha Erkoc ◽  
Hayriye Sayarlioglu ◽  
Kursat Uzun

1997 ◽  
Vol 13 (6) ◽  
pp. 248-251
Author(s):  
Jennifer H Tran ◽  
John D Seeger

Objective: To review the literature discussing the use of two-step tuberculin skin testing for hospital employees. Data Sources: English-language journal articles involving human subjects. Study Selection: Selected articles describing the use of two-step tuberculin skin testing. Data Extraction: Information relevant to the topic was extracted from the articles and synthesized into this report. Data Synthesis: People infected with tuberculosis exhibit a skin-test reaction to tuberculin, but this reaction can diminish over time. A two-step tuberculin skin test involves the administration of a second injection of tuberculin 1–3 weeks after the initial injection. The rationale for the use of the two-step tuberculin skin test is to help differentiate between individuals with new tuberculosis infections and those with previous infections whose immune response to tuberculin had decreased to levels not detectable with a single skin test. Conclusions: Two-step tuberculin skin testing is effective at detecting a booster effect. Despite the recent mandate by the Occupational Safety and Health Administration to use two-step tuberculin testing in all healthcare facilities, such testing may not be cost-effective in institutions with young employees, high employee turnover, and a low risk of tuberculosis. The requirements for universal two-step tuberculin testing may need to be reevaluated to account for these factors.


2009 ◽  
Vol 30 (12) ◽  
pp. 1230-1232 ◽  
Author(s):  
Scott H. James ◽  
Juan A. Dumois ◽  
Allison F. Messina ◽  
Jay L. Gould ◽  
David M. Berman

A cross-sectional survey of 210 healthcare workers at a pediatric teaching hospital was performed to assess knowledge of published guidelines for proper measurement and documentation of tuberculin skin test Results. We conclude that many healthcare workers have inadequate knowledge for optimal measurement and documentation of tuberculin skin test results.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sabine Steinbach ◽  
Sasan Jalili-Firoozinezhad ◽  
Sreenidhi Srinivasan ◽  
Mariane B. Melo ◽  
Sonya Middleton ◽  
...  

AbstractBovine tuberculosis (bTB) is a disease of livestock with severe and worldwide economic, animal welfare and zoonotic consequences. Application of test-and-slaughter-based control polices reliant on tuberculin skin testing has been the mainstay of bTB control in cattle. However, little is known about the temporal development of the bovine tuberculin skin test response at the dermal sites of antigen injection. To fill this knowledge gap, we applied minimally-invasive sampling microneedles (SMNs) for intradermal sampling of interstitial fluid at the tuberculin skin test sites in Mycobacterium bovis BCG-vaccinated calves and determined the temporal dynamics of a panel of 15 cytokines and chemokines in situ and in the peripheral blood. The results reveal an orchestrated and coordinated cytokine and local chemokine response, identified IL-1RA as a potential soluble biomarker of a positive tuberculin skin response, and confirmed the utility of IFN-γ and IP-10 for bTB detection in blood-based assays. Together, the results highlight the utility of SMNs to identify novel biomarkers and provide mechanistic insights on the intradermal cytokine and chemokine responses associated with the tuberculin skin test in BCG-sensitized cattle.


2018 ◽  
Vol 39 (6) ◽  
pp. 750-752 ◽  
Author(s):  
Jeffrey M. Collins ◽  
Mary Hunter ◽  
Wanda Gordon ◽  
Russell R. Kempker ◽  
Henry M. Blumberg ◽  
...  

Following large declines in tuberculosis transmission the United States, large-scale screening programs targeting low-risk healthcare workers are increasingly a source of false-positive results. We report a large cluster of presumed false-positive tuberculin skin test results in healthcare workers following a change to 50-dose vials of Tubersol tuberculin.Infect Control Hosp Epidemiol 2018;39:750–752


2001 ◽  
Vol 22 (7) ◽  
pp. 449-455 ◽  
Author(s):  
Jerome I. Tokars ◽  
George F. McKinley ◽  
Joan Otten ◽  
Charles Woodley ◽  
Emilia M. Sordillo ◽  
...  

AbstractObjective:To evaluate the implementation and efficacy of selected Centers for Disease Control and Prevention guidelines for preventing spread ofMycobacterium tuberculosis.Design:Analysis of prospective observational data.Setting:Two medical centers where outbreaks of multidrug-resistant tuberculosis (TB) had occurred.Participants:All hospital inpatients who had active TB or who were placed in TB isolation and healthcare workers who were assigned to selected wards on which TB patients were treated.Methods:During 1995 to 1997, study personnel prospectively recorded information on patients who had TB or were in TB isolation, performed observations of TB isolation rooms, and recorded tuberculin skin-test results of healthcare workers. Genetic typing ofM tuberculosisisolates was performed by restriction fragment-length polymorphism analysis.Results:We found that only 8.6% of patients placed in TB isolation proved to have TB; yet, 19% of patients with pulmonary TB were not isolated on the first day of hospital admission. Specimens were ordered for acid-fast bacillus smear and results received promptly, and most TB isolation rooms were under negative pressure. Among persons entering TB isolation rooms, 44.2% to 97.1% used an appropriate (particulate, high-efficiency particulate air or N95) respirator, depending on the hospital and year; others entering the rooms used a surgical mask or nothing. We did not find evidence of transmission of TB among healthcare workers (based on tuberculin skin-test results) or patients (based on epidemiological investigation and genetic typing).Conclusions:We found problems in implementation of some TB infection control measures, but no evidence of healthcare-associated transmission, possibly in part because of limitations in the number of patients and workers studied. Similar evaluations should be performed at hospitals treating TB patients to find inadequacies and guide improvements in infection control.


2008 ◽  
Vol 41 (4) ◽  
pp. 416-418 ◽  
Author(s):  
Florian H. Pilsczek ◽  
Stefan H.E. Kaufmann

Latent tuberculosis was studied in a research laboratory. A prevalence of positive tuberculin skin test results (> 15mm) of 20% was found and the main predictors were place of birth in a foreign country with high prevalence of tuberculosis and a history of contact with patients with untreated active tuberculosis.


1998 ◽  
Vol 6 (1) ◽  
pp. 13-17 ◽  
Author(s):  
N. L. Eriksen ◽  
A. W. Helfgott

Objective:To determine the prevalence of cutaneous anergy in pregnant and nonpregnant women who are seropositive for human immunodeficiency virus.Methods and materials:The medical records of 159 women seropositive for human immunodeficiency virus were reviewed. Demographic characteristics and tuberculin skin test results were abstracted from the chart. Tuberculin skin testing was performed by the Mantoux method (5 tuberculin units of purified protein derivative injected intradermally). Anergy testing was performed using any two of the three following antigens; tetanus toxoid, mumps, orCandidaskin test antigen. A positive tuberculin test was defined as induration of 5 mm or more, and a positive test for the other antigens was defined as any amount of induration over the skin test area. Anergy was defined as any amount of induration to the other antigens. A CD4+T lymphocyte count was obtained at the time of skin testing. Continuous variables were analyzed using the Mann Whitney—U test. Categorical data were analyzed with the chi-square or Fisher's exact test as appropriate. A two-tailedPvalue <0.05 was considered significant.Results:There were 102 nonpregnant and 57 pregnant women who returned to have their skin test results read. There was no significant difference in the prevalence of positive, negative or anergic skin test results between groups. The CD4+T lymphocyte count (mean ± standard deviation) in patients with anergic results was similar between pregnant (375 ± 256/mm3) and nonpregnant (358 ± 305/mm3) women (P= 0.64).Conclusion:The prevalence of cutaneous anergy is similar among pregnant and nonpregnant women seropositive for human immunodeficiency virus.


2003 ◽  
Vol 17 (3) ◽  
pp. 159-162
Author(s):  
Jason S. Krahnke ◽  
Deborah A. Gentile ◽  
Kelly M. Cordoro ◽  
Betty L. Angelini ◽  
Sheldon A. Cohen ◽  
...  

Background Few studies have examined the relationship between subject-reported allergy and results of allergy skin testing in large unselected or unbiased cohorts. The objective of this study was to compare the results of self-reported allergy via verbal questioning with the results of allergy skin testing by the puncture method in 237 healthy adult subjects enrolled in a common cold study. Methods On enrollment, all subjects were verbally asked if they had a history of allergy and then underwent puncture skin testing to 19 relevant aeroallergens, as well as appropriate positive and negative controls. A skin test was considered positive if its wheal diameter was at least 3 mm larger than that obtained with the negative control. Results Forty-eight (20%) subjects reported a history of allergy and 124 (52%) subjects had at least one positive skin test response. A history of allergy was reported in 40 (32%) of the skin test-positive subjects and 8 (7%) of the skin test-negative subjects. At least one positive skin test response was found in 40 (83%) of those subjects reporting a history of allergy and 84 (44%) of those subjects denying a history of allergy. Conclusion These data indicate that there is a relatively poor correlation between self-reported history of allergy and skin test results in subjects enrolled in a common cold study. These results have implications in both clinical practice and research settings.


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