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Annual Incidence of Latent Tuberculosis Infection among Newly Employed Nurses at a Tertiary Care University Hospital

Published online by Cambridge University Press:  02 January 2015

Kwangha Lee
Affiliation:
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Min Kyoung Han
Affiliation:
Department of Infectious Control, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Hye Ran Choi
Affiliation:
Department of Infectious Control, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Chang-Min Choi
Affiliation:
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Yeon-Mok Oh
Affiliation:
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Sang Do Lee
Affiliation:
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Woo Sung Kim
Affiliation:
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Dong Soon Kim
Affiliation:
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Jun Hee Woo*
Affiliation:
Department of Infectious Control, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
Tae Sun Shim*
Affiliation:
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
*
Department of Infection Control, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea (junheewoo@amc.seoul.kr)
Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2 dong, Songpa-gu, Seoul, 138-736, Korea (shimts@amc.seoul.kr)

Abstract

Objective.

To investigate the annual rate of tuberculosis (TB) infection among newly employed nurses using both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G; Cellestis Limited) assay.

Design.

A prospective cohort study involving newly employed nurses.

Setting.

A tertiary care university hospital in South Korea.

Methods.

All participants (n = 196) were tested with the TST and QFT-G assay at baseline. After 1 year, the TST and QFT-G assay were reperformed for subjects who had negative TST results at baseline and for all subjects, respectively.

Results.

The baseline TST and QFT-G assays were positive for 101 subjects (51.5%) and 28 subjects (14.3%), respectively; 22 subjects (11.2%) had positive results of both tests. Although the overall between-test agreement was 54.9% (κ = 0.151 [95% confidence interval, 0.047–0.245]), agreement improved to 78.5% (κ = 0.462 [95% confidence interval, 0.007–0.917]) for subjects who had not received bacille Calmette-Guérin vaccination. After 1 year, the TST yielded positive results for 16 (21.3%) of 75 nurses with negative baseline results, and the QFT-G assay yielded positive results for 21 (14.4%) of 146 subjects with negative baseline Results. Collectively, 5 subjects (3.0%) experienced conversion to positive results with both tests, and 32 subjects (18.9%) experienced conversion to positive results with one of the tests. Neither the employing hospital department nor exposure to patients with TB affected test conversion status.

Conclusions.

The poor overall agreement between TST and QFT-G results may have been caused by the confounding effect of bacille Calmette-Guérin vaccination. The annual risk of TB infection among newly employed nurses was at least 3% on the basis of results of both the TST and QFT-G test. Stricter preventive strategies against TB spread should be implemented in our hospital.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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