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Tuberculosis & Respiratory Diseases

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Vol.75 No.1
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Prevalence of Latent Tuberculosis Infection among Health Care Workers in South Korea: A Multicenter Study

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2013, v.75 no.1, pp.18-24

Yoonki Hong (University of Ulsan College of Medicine)



Sang-Rok Lee (Cheongju St. Mary’s Hospital)


Jung Yeon Heo (Armed Forces Capital Hospital)


Yoonki, H. , Sang-Rok, L. , Jung, Y. H. , & (2013). Prevalence of Latent Tuberculosis Infection among Health Care Workers in South Korea: A Multicenter Study. Tuberculosis & Respiratory Diseases, 75(1), 18-24.
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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
Latent Tuberculosis, Health Personnel, Tuberculin Test, Interferon-gamma Release Tests, Republic of Korea

Reference

1.

Menzies D, Fanning A, Yuan L, Fitzgerald M. Tuberculosis among health care workers. N Engl J Med 1995;332:92-8.

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.

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.

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.

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.

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.

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.

10.

Sokal JE. Editorial: Measurement of delayed skin-test responses. N Engl J Med 1975;293:501-2.

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.

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.

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.

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.

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.

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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