Screening for Tuberculosis Infection in Spanish Healthcare Workers Comparison of the QuantiFERON-TB Gold In-Tube Test with the Tuberculin Skin Test

2009 ◽  
Vol 30 (9) ◽  
pp. 876-883 ◽  
Author(s):  
Eva Elisa Àlvarez-León ◽  
Elizabeth Espinosa-Vega ◽  
Évora Santana-Rodríguez ◽  
Jesús M. Molina-Cabrillana ◽  
Jose Luis Pérez-Arellano ◽  
...  
Keyword(s):  
Positive Result ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Healthcare Workers ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Negative Results

Objective.The risk of latent tuberculosis (LTBI) in healthcare workers (HCWs) is high. Until recently, the tuberculin skin test (TST) was the only diagnostic test available for Mycobacterium tuberculosis infection. A new enzyme-linked immunosorbent assay test, the QuantiFERON-TB Gold (QFT-G) test, was recommended by the US Centers for Disease Control and Prevention as an alternative test for the diagnosis of LTBI in HCWs. The purpose of our study was to compare the TST and the QFT-G test in Spanish HCWs in order to improve procedures for the detection of LTBI.Methods.A cross-sectional study with blinded comparison of TST and QFT-G test results was carried out among 134 HCWs at an 800-bed Spanish university hospital. The level of interferon-7 production stimulated by the QFT-G test was measured. A concentration of at least 0.35 IU/mL was considered a positive result. An induration of at least 5 mm in non-BCG-vaccinated or at least 15 mm in BCG-vaccinated HCWs for the TST was considered positive.Results.Of the 134 HCWs included (mean age, 33.4 years; 101 [75.4%] women; 47 [35.1%] BCG vaccinated), the LTBI prevalence diagnosed with any test was 11.2% (95% confidence interval, 6.6%-18.1%), with the TST was 8.96%, and with the QFT-G test was 5.97% (nonsignificant differences). The QFT-G test value was higher in subjects with TST induration of at least 15 mm than in subjects with TST induration of less than 15 mm (P < .001). Overall agreement between the results of the two tests was found in 94% of HCWs (K = 0.56), but agreement was only 59% in HCWs who had a positive result for both tests. Disagreement was present in the results found for 5% of HCWs.Conclusions.Few studies have compared both tests in populations with high M. tuberculosis exposure but low BCG vaccination prevalence. Agreement between both tests is high, especially among negative Results. Studies are needed to clarify the reasons for disagreement and to establish the best TST and QFT-G test cutoff point.

scholarly journals Steroids Decrease Prevalence of Positive Tuberculin Skin Test in Rheumatoid Arthritis: Implications on Anti-TNF Therapies

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Shweta Agarwal ◽  
Siddharth Kumar Das ◽  
Girdhar G. Agarwal ◽  
Ragini Srivastava
Keyword(s):  
Rheumatoid Arthritis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Standard Treatment ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Positive Tuberculin Skin Test ◽  
Test Results ◽  
Disease Modifying Antirheumatic Drugs ◽  
Cross Sectional

Tuberculin skin test has been used as an indicator of latent tuberculosis in patients with Rheumatoid Arthritis (RA) before administration of biologicals. Effect of Disease modifying antirheumatic drugs (DMARDs) and steroids on the result of tuberculin skin test (TST) may have important implications in interpretation of results of this test.Objectives. To find the prevalence of positive TST in rheumatoid patients and the effect of standard treatment on the results of TST.Method. In this cross-sectional study two hundred and fifty patients of RA above 18 years of age, classified using 1987 ACR criteria for RA, were enrolled from rheumatology outdoor. Demographics, disease activity, disease duration, and therapy were recorded. All patients underwent TST.Results. Fifty-one (20.4%) patients were found to be tuberculin positive. Tuberculin positivity was not affected by MTX intake but it was significantly low in patients with recent steroid intake as compared to patients who had not taken steroids in last 3 months (3% versus 25%,P= 0.002).Conclusion. Prevalence of tuberculin positivity in patients with RA was found to be low. Results were not affected by methotrexate; however tuberculin skin test results in patients with recent use of steroids are likely to be negative.

scholarly journals Comparison of the QuantiFERON-TB and tuberculin skin test for detection of latent tuberculosis infection in cancer patients in a developing country

2019 ◽  
Vol 5 (4) ◽  
pp. 00258-2018
Author(s):  
Javier Leonardo Galindo ◽  
Adriana Catalina Galeano ◽  
David Alfonso Suarez-Zamora ◽  
Ana Milena Callejas ◽  
Mónica Patricia Caicedo-Verástegui ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Cancer Patients ◽  
Skin Test ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Tuberculosis Infection ◽  
Test Results ◽  
Cross Sectional ◽  
Increased Risk

Cancer patients have an increased risk of reactivation of latent tuberculosis infection. It is unknown which strategy on screening should be used in this population in developing countries. We aimed to determine the concordance between the tuberculin skin test (TST) and QuantiFERON®-TB (QFT) assay in order to diagnose latent tuberculosis infection in cancer patients.We conducted a cross-sectional study of the agreement of diagnostic tests. Prevalence and agreement between tests were calculated. A logistic regression to assess predictors of discordance was performed. The accuracy of the TST to predict QFT results by a receiver operating characteristic (ROC) curve was evaluated.We included 149 adults with cancer without active tuberculosis. Prevalence of latent tuberculosis infection was 21.5% (n=32), defined as positive results on either test. Test agreement was moderate for the diagnosis of latent tuberculosis infection (κ=0.43, 90% CI 0.26–0.6). No predictor was associated with the chance of discordant results. Agreement improved slightly using a cut-off point ≥8 mm (κ=0.5, 90% CI 0.35–0.66).In a moderate-incidence setting, a moderate agreement was found between tests in cancer patients. Modification of the cut-off points of test results achieved marginally better agreement between the TST and QFT.

Prevalence of Thyroid Diseases in an Occupationally Radiation Exposed Group: A Cross-Sectional Study in a University Hospital of Southern Italy

2019 ◽  
Vol 19 (6) ◽  
pp. 803-808 ◽  
Author(s):  
Luigi Vimercati ◽  
Luigi De Maria ◽  
Francesca Mansi ◽  
Antonio Caputi ◽  
Giovanni M. Ferri ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Healthcare Workers ◽  
Southern Italy ◽  
Cross Sectional Study ◽  
Thyroid Diseases ◽  
University Hospital ◽  
Control Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Exposed Workers

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.

scholarly journals Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit

2019 ◽  
Vol 13 (08) ◽  
pp. 744-747 ◽  
Author(s):  
Uluhan Sili ◽  
Pinar Ay ◽  
Huseyin Bilgin ◽  
Seyhan Hidiroglu ◽  
Volkan Korten
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Compliance Rate ◽  
Cross Sectional Study ◽  
University Hospital ◽  
World Health ◽  
Training Methods ◽  
Cross Sectional

Introduction: While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. Methodology: A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Results: Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for “before clean/aseptic procedure” indication and highest compliance was 68.6% for “after touching a patient” indication. Although > 90% healthcare workers correctly identified the World Health Organization’s five indications for HH, 82 – 85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Conclusions: Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.

scholarly journals Comparison between the Interferon γ Release Assay—QuantiFERON Gold Plus (QFT-Plus)—and Tuberculin Skin Test (TST) in the Detection of Tuberculosis Infection in Immunocompromised Children

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Cory Primaturia ◽  
Lelani Reniarti ◽  
Heda M. N. Nataprawira
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Hematologic Malignancy ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Kappa Index ◽  
Cross Sectional ◽  
Paediatric Patients ◽  
Number Of Patients ◽  
Positive Results

Background. Immunocompromised patients are at a higher risk of having latent tuberculosis infection (LTBI). QuantiFERON-TB Gold Plus (QFT-Plus) has been proven to perform effectively in LTBI detection among immunocompromised adults and can overcome the limitations of the tuberculin skin test (TST). However, the role of QFT-Plus in detecting LTBI in immunocompromised paediatric patients has not been well established. Therefore, the aim of this study was to assess the test agreement between QFT-Plus and the TST in LTBI detection among immunocompromised children. Method. In this cross-sectional study, we enrolled immunocompromised paediatric patients, aged between 5 and 18 years, who were treated with corticosteroids and/or chemotherapy from June to November 2019. We categorized them into three groups based on the following diseases: hematologic malignancies and nephrological and immunological diseases. We recorded the patient characteristics and QFT-Plus and TST results, in which the positive result of the TST was induration≥5 mm. Within the same group, comparisons between the two tests were performed using the McNemar test, and results were statistically significant for p values of <0.05. The kappa index was used to assess the agreement between the two test results. Results. Among 71 patients (median age: 11.8 years) who underwent TST and QFT-Plus testing, 52% were females, and 69% had a normal nutritional status. Chemotherapy was the most common treatment modality for hematologic malignancy compared to other immunosuppressive treatments. The total number of patients with positive QFT-Plus and TST results was 11/71 (15.5%) and 4/71 (5.6%), respectively, among whom 3/11 patients had positive results in both tests, and one patient with positive TST results exhibited a discrepancy, as this was not followed by positive QFT-Plus results. QFT-Plus generated more positive results than the TST in immunocompromised children (McNemar, p=0.039 (p<0.05)). The diagnostic agreement between the tests was fair (K=0.345, 95% CI: 0.05–0.745). Conclusion. QFT-Plus detected LTBI more effectively than the TST in immunocompromised children.

Healthcare Worker Knowledge of Measurement and Documentation of Tuberculin Skin Test Reaction

2009 ◽  
Vol 30 (12) ◽  
pp. 1230-1232 ◽  
Author(s):  
Scott H. James ◽  
Juan A. Dumois ◽  
Allison F. Messina ◽  
Jay L. Gould ◽  
David M. Berman
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Healthcare Workers ◽  
Test Results ◽  
Cross Sectional Survey ◽  
Test Reaction ◽  
Cross Sectional ◽  
Inadequate Knowledge ◽  
Tuberculin Skin Test Reaction ◽  
Skin Test Reaction

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.

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