938Identification of High Risk Healthcare Workers with Latent Tuberculosis Infection (LTBI) in an Inner City Healthcare System

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

Download Full-text

Diagnosis and Treatment of Latent Tuberculosis Infection in Healthcare Workers

Tuberculosis and Respiratory Diseases ◽

10.4046/trd.2016.79.3.127 ◽

2016 ◽

Vol 79 (3) ◽

pp. 127 ◽

Cited By ~ 4

Author(s):

Jeong Ha Mok

Keyword(s):

Healthcare Workers ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Tuberculosis Infection ◽

Diagnosis And Treatment

Download Full-text

Incidence of occupational latent tuberculosis infection in South African healthcare workers

European Respiratory Journal ◽

10.1183/09031936.00138414 ◽

2015 ◽

Vol 45 (5) ◽

pp. 1364-1373 ◽

Cited By ~ 27

Author(s):

Shahieda Adams ◽

Rodney Ehrlich ◽

Roslynn Baatjies ◽

Richard N. van Zyl-Smit ◽

Qonita Said-Hartley ◽

...

Keyword(s):

South African ◽

Conversion Rate ◽

Healthcare Workers ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Control Measures ◽

Sub Saharan Africa ◽

Tuberculosis Infection ◽

Healthcare Sector ◽

Conversion Rates

The test-specific incidence of latent tuberculosis infection (LTBI) in healthcare workers from sub-Saharan Africa is unknown.505 healthcare workers from South Africa were screened at baseline, and after 12 months, with a questionnaire, the tuberculin skin test (TST), and two T-cell assays (T-SPOT.TB and QuantiFERON-TB Gold-In-Tube). Test-specific conversion rates were calculated.The prevalence of presumed LTBI at baseline was 84, 69 and 62% using the TST, QuantiFERON-TB Gold-In-Tube and T-SPOT.TB, respectively. The annual test-specific conversion rate, depending on the cut-off point used, was as follows: TST 38%; QuantiFERON-TB Gold-In-Tube 13–22%; and T-SPOT.TB 18–22%. Annual reversion rates were 4, 7 and 16%, respectively. The annual TST conversion rate was significantly higher than that derived from published local community-based data (IRR 3.53, 95% CI 1.81–6.88). Factors associated with conversion (any test) included healthcare sector of employment, counselling of tuberculosis patients, and a baseline positive TST (for T-SPOT.TB).The annual rate of tuberculosis infection in South African healthcare workers was very high, irrespective of the testing method used, and may be explained by occupational exposure, as the rate was considerably higher than non-healthcare workers from the same community. Collectively, these data support the need for implementation of tuberculosis-specific infection control measures in Africa.

Download Full-text

Recommendations for the screening of paediatric latent tuberculosis infection in indigenous communities: a systematic review of screening strategies among high-risk groups in low-incidence countries

BMC Public Health ◽

10.1186/s12889-018-5886-7 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

Lena Faust ◽

Anne McCarthy ◽

Yoko Schreiber

Keyword(s):

Systematic Review ◽

High Risk ◽

Latent Tuberculosis Infection ◽

Latent Tuberculosis ◽

Indigenous Communities ◽

Risk Groups ◽

Tuberculosis Infection ◽

Screening Strategies ◽

Low Incidence

Download Full-text

Factors Associated with Latent Tuberculosis Infection among the Hospital Employees in a Tertiary Hospital of Northeastern Thailand

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186876 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6876

Author(s):

Patimaporn Chanpho ◽

Naesinee Chaiear ◽

Supot Kamsa-ard

Keyword(s):

High Risk ◽

Latent Tuberculosis Infection ◽

Conditional Logistic Regression ◽

Critical Role ◽

Latent Tuberculosis ◽

Tertiary Hospital ◽

Tuberculosis Infection ◽

P Value ◽

Factors Associated ◽

Northeastern Thailand

Latent tuberculosis infection (LTBI) can develop into tuberculosis (TB). The WHO requires the discovery and management of LTBI among high-risk groups. Health care workers (HCWs) constitute a high-risk group. Factors associated with LTBI among HCWs in Thailand need further study. The current study aimed to explore the factors related to LTBI among Thai HCWs. A hospital-based, matched case-control study was conducted. All cases and controls were HCWs at a tertiary hospital in northeastern Thailand. Between 2017 and 2019, a total of 85 cases of interferon-γ release assays (IGRAs)-proven LTBI, and 170 control subjects were selected from a hospital (two controls per case). The two recruited controls were individually matched with LTBI cases by sex and age (±5 years). Secondary data were obtained from the occupational health and safety office. Case HCWs had a higher proportion of significant factors than control HCWs (i.e., working closely with pulmonary TB—94.1% vs. 88.8%, and working in the area of aerosol-generating procedures (AGPs) 81.2% vs. 69.4%). The bivariate conditional logistic regression showed that the occurrence of LTBI in HCWs was statistically significant (p-value < 0.05), particularly with respect to: workplaces of AGPs (crude OR = 1.90, 95% CI: 1.01–3.58, p = 0.041); among HCWs performing AGPs (crude OR = 2.04, 95% CI: 1.20, 3.48, p = 0.007); and, absent Bacille Calmette-Guérin (BCG) scar (crude OR = 2.59, 95% CI: 1.50–4.47, p = 0.001). Based on the multivariable conditional logistics analysis, HCWs who performed AGPs while contacting TB cases had a statistically significant association with LTBI (adjusted OR = 1.82, 95% CI: 1.04–3.20, p = 0.035). HCWs who reported the absence of a BCG scar had a statistically significant association with LTBI (adjusted OR = 2.49, 95% CI: 1.65–5.36, p = 0.001), whereas other factors including close contact with TB (adjusted OR = 2.44, 95% CI: 0.74, 8.09, p = 0.123) were not significantly associated with LTBI. In conclusion, HCWs who performed AGPs and were absent a BCG scar had a significant association with LTBI, while other factors played a less critical role.

Download Full-text