Pediatr Infect Vaccine.  2016 Aug;23(2):94-101. 10.14776/piv.2016.23.2.94.

A Tuberculosis Contact Investigation on Health Care Workers in One Hospital

Affiliations
  • 1Department of Pediatrics, Hanyang University Hospital, Seoul, Korea. sungheeo@hanyang.ac.kr
  • 2Department of Infection Control, Hanyang University Hospital, Seoul, Korea.
  • 3Department of Internal Medicine, National Medical Center, Seoul, Korea.
  • 4Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea.

Abstract

PURPOSE
This study aimed to describe the results of a contact investigation on health care workers after exposure to a house officer with smear-positive pulmonary tuberculosis (TB).
METHODS
Eighty nine out of 101 subjects who had close contact with the index patient agreed to be enrolled in the investigation. The first contact investigation was conducted approximately 30 days after the index patient's onset of symptoms, followed by the second investigation after 10 weeks. In both, clinical manifestations were studied, and chest X-ray and tuberculin skin test (TST)/QuantiFERON-TB Gold (QFT-G) in dual screening strategy were conducted.
RESULTS
The first TST resulted in positive in 34 subjects (38.2%). QFT-G was conducted on 16 subjects who tested positive in the first TST and aged under 36. Six of them (37.5%) were positive. The second TST was conducted on 41 subjects with negative results in the first TST. Seventeen (41.5%) were positive and among them, three (17.6%) showed positive QFT-G. None of the subjects were diagnosed with active TB. The probability of TB infection through contact with the index patient was 7.3% (3/41) in dual screening strategy while it was 41.5% (17/41) in TST strategy.
CONCLUSIONS
This first hospital-setting contact investigation for tuberculosis in Korea revealed that latent tuberculosis infection (LTBI) rates vary depending on different diagnostic strategies. This indicates the need for systematic guidelines for diagnosing LTBI in health care workers who have professional exposure to TB.

Keyword

Latent tuberculosis infection; Health care worker; Tuberculin skin test; Interferon-gamma release assay

MeSH Terms

Delivery of Health Care*
Humans
Interferon-gamma Release Tests
Korea
Latent Tuberculosis
Mass Screening
Skin Tests
Thorax
Tuberculin
Tuberculosis*
Tuberculosis, Pulmonary
Tuberculin

Figure

  • Fig. 1 Flow chart of contact investigation. Abbreviations: TST, Tuberculin skin test; CXR, Chest x-ray; QFT-G, QuantiFERON-TB gold.


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