Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prevalence of Latent Tuberculosis Infection among Health Care Workers in South Korea: A Multicenter Study

  • Jo, Kyung-Wook (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Yoonki (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Jae Seuk (Department of Internal Medicine, Dankook University College of Medicine) ;
  • Bae, In-Gyu (Department of Internal Medicine, Gyeongsang National University School of Medicine) ;
  • Eom, Joong Sik (Division of Infectious Diseases, Department of Internal Medicine, Kandong Sacred Heart Hospital College of Medicine, Hallym University College of Medicine) ;
  • Lee, Sang-Rok (Department of Internal Medicine, Division of Allergy and Infectious Diseases, Cheongju St. Mary's Hospital) ;
  • Cho, Oh-Hyun (Department of Internal Medicine, Gyeongsang National University School of Medicine) ;
  • Choo, Eun Ju (Division of Infectious Diseases, Department of Internal Medicine, Soon Chun Hyang University Bucheon Hospital, Soon Chun Hyang University College of Medicine) ;
  • Heo, Jung Yeon (Department of Internal Medicine, Armed Forces Capital Hospital) ;
  • Woo, Jun Hee (Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shim, Tae Sun (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2012.11.25
  • Accepted : 2013.04.01
  • Published : 2013.07.30
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Abstract

Background: We investigated the prevalence of latent tuberculosis infection (LTBI) among the health care workers (HCWs) and analyzed its risk factors in South Korea. Methods: A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. Results: A total of 493 participants, 152 (30.8%) doctors and 341 (69.2%) nurses were enrolled in eight tertiary referral hospitals. The mean age of the subjects was 30.6 years old, and 383 (77.7%) were female. Of the 152 doctors, 63 (41.4%) and 36 (23.7%) were positive by TST and by QTF-GIT, respectively, and among the 341 nurses, 119 (34.9%) and 49 (14.4%) had positive TST and QFT-GIT results, respectively. Overall, the agreement between the two tests was 0.22 by the chance corrected proportional agreement rate (kappa coefficient) in 493 subjects. Experience of working in tuberculosis (TB)-related departments was significantly associated with positive LTBI test results by QFT-GIT assay, not by TST. In multivariate analysis, only age was independently associated with increased risk of a positive TST result, while age and experience of working in TB-related departments (odds ratio, 2.29; 95% confidence interval, 1.01-5.12) were independently associated with increased risk of a positive QFT-GIT result. Conclusion: A high prevalence of LTBI was found among South Korean HCWs. Considering the association between the experience of working in TB-related departments and high risk of LTBI, QFT-GIT may be a better diagnostic test for LTBI than TST in HCWs.

Keywords

References

  1. Menzies D, Fanning A, Yuan L, Fitzgerald M. Tuberculosis among health care workers. N Engl J Med 1995;332:92-8. https://doi.org/10.1056/NEJM199501123320206
  2. Baussano I, Nunn P, Williams B, Pivetta E, Bugiani M, Scano F. Tuberculosis among health care workers. Emerg Infect Dis 2011;17:488-94. https://doi.org/10.3201/eid1703.100947
  3. Kim SJ, Lee SH, Kim IS, Kim HJ, Kim SK, Rieder HL. Risk of occupational tuberculosis in National Tuberculosis Programme laboratories in Korea. Int J Tuberc Lung Dis 2007;11:138-42.
  4. Rafiza S, Rampal KG, Tahir A. Prevalence and risk factors of latent tuberculosis infection among health care workers in Malaysia. BMC Infect Dis 2011;11:19. https://doi.org/10.1186/1471-2334-11-19
  5. Khanna P, Nikolayevskyy V, Warburton F, Dobson E, Drobniewski F. Rate of latent tuberculosis infection detected by occupational health screening of nurses new to a london teaching hospital. Infect Control Hosp Epidemiol 2009;30:581-4. https://doi.org/10.1086/597546
  6. Lee KJ, Kang YA, Kim YM, Cho SN, Moon JW, Park MS, et al. Screening for latent tuberculosis infection in South Korean healthcare workers using a tuberculin skin test and whole blood interferon-gamma assay. Scand J Infect Dis 2010;42: 672-8. https://doi.org/10.3109/00365548.2010.485575
  7. Lee K, Han MK, Choi HR, Choi CM, Oh YM, Lee SD, et al. Annual incidence of latent tuberculosis infection among newly employed nurses at a tertiary care university hospital. Infect Control Hosp Epidemiol 2009;30:1218-22. https://doi.org/10.1086/648082
  8. Jo KW, Woo JH, Hong Y, Choi CM, Oh YM, Lee SD, et al. Incidence of tuberculosis among health care workers at a private university hospital in South Korea. Int J Tuberc Lung Dis 2008;12:436-40.
  9. Park HY, Jeon K, Suh GY, Kwon OJ, Chung DR, Yoonchang SW, et al. Interferon-gamma release assay for tuberculosis screening of healthcare workers at a Korean tertiary hospital. Scand J Infect Dis 2010;42:943-5. https://doi.org/10.3109/00365548.2010.524658
  10. Sokal JE. Editorial: Measurement of delayed skin-test responses. N Engl J Med 1975;293:501-2. https://doi.org/10.1056/NEJM197509042931013
  11. Mori T, Sakatani M, Yamagishi F, Takashima T, Kawabe Y, Nagao K, et al. Specific detection of tuberculosis infection: an interferon-gamma-based assay using new antigens. Am J Respir Crit Care Med 2004;170:59-64. https://doi.org/10.1164/rccm.200402-179OC
  12. Kang YA, Lee HW, Yoon HI, Cho B, Han SK, Shim YS, et al. Discrepancy between the tuberculin skin test and the wholeblood interferon gamma assay for the diagnosis of latent tuberculosis infection in an intermediate tuberculosis-burden country. JAMA 2005;293:2756-61. https://doi.org/10.1001/jama.293.22.2756
  13. Jo KW, Jeon K, Kang YA, Koh WJ, Kim KC, Kim YH, et al. Poor correlation between tuberculin skin tests and interferongamma assays in close contacts of patients with multidrugresistant tuberculosis. Respirology 2012;17:1125-30. https://doi.org/10.1111/j.1440-1843.2012.02218.x
  14. Drobniewski F, Balabanova Y, Zakamova E, Nikolayevskyy V, Fedorin I. Rates of latent tuberculosis in health care staff in Russia. PLoS Med 2007;4:e55. https://doi.org/10.1371/journal.pmed.0040055
  15. Torres Costa J, Sa R, Cardoso MJ, Silva R, Ferreira J, Ribeiro C, et al. Tuberculosis screening in Portuguese healthcare workers using the tuberculin skin test and the interferon-gamma release assay. Eur Respir J 2009;34:1423-8. https://doi.org/10.1183/09031936.00053809
  16. Mirtskhulava V, Kempker R, Shields KL, Leonard MK, Tsertsvadze T, del Rio C, et al. Prevalence and risk factors for latent tuberculosis infection among health care workers in Georgia. Int J Tuberc Lung Dis 2008;12:513-9.

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