In-hospital contact investigation among health care workers after exposure to pulmonary tuberculosis in an intermediate tuberculosis prevalence area: A prospective study

Arch Environ Occup Health. 2017 Sep 3;72(5):272-278. doi: 10.1080/19338244.2016.1217823. Epub 2016 Jul 29.

Abstract

We carried out in-hospital contact investigations of patients with pulmonary tuberculosis and analyzed the prevalence of latent tuberculosis infection (LTBI) among health care workers (HCWs) after TB exposure. A prospective study was conducted of 872 HCWs who were exposed to 55 index cases diagnosed with active pulmonary TB. HCWs after TB exposure were evaluated both TST and chest X-ray at the time of enrollment and 12 weeks after exposure; 625 HCWs (71.6%) underwent both initial assessments; 41 HCWs (6.6%) had a positive TST result. After 12 weeks, 71.1% of HCWs with initial negative TST (n = 415) underwent a second assessment. Ten HCWs had TST conversion. One HCW (0.2%) developed active pulmonary TB. In multivariable analysis, age over 30 years was associated with TST conversion (p = .02). Point prevalence of latent TB was 6.6%, and incidence of LTBI was estimated as 2.4 per 100 HCWs. Strict infection control measures should be emphasized in intermediate TB-burden, BCG-vaccinated countries, especially in HCWs with high risk for TB exposure.

Keywords: Health care worker; infection control; tuberculin skin test; tuberculosis.

MeSH terms

  • Adult
  • Cross Infection / transmission*
  • Female
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / statistics & numerical data
  • Latent Tuberculosis / epidemiology
  • Latent Tuberculosis / transmission
  • Male
  • Occupational Exposure / adverse effects
  • Occupational Exposure / statistics & numerical data
  • Personnel, Hospital / statistics & numerical data
  • Prevalence
  • Prospective Studies
  • Republic of Korea / epidemiology
  • Tuberculin Test
  • Tuberculosis, Pulmonary / epidemiology
  • Tuberculosis, Pulmonary / transmission*