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. 2020 Jun;48(6):650-655.
doi: 10.1016/j.ajic.2019.10.014. Epub 2019 Dec 2.

A retrospective review of tuberculosis exposure among health care workers in a tertiary hospital

Shi Zhe Gabriel Chia  1 , Kue Bien Molly How  2 , Maciej Piotr Chlebicki  2 , Moi Lin Ling  2 , Wee Hoe Gan  2
Affiliations

A retrospective review of tuberculosis exposure among health care workers in a tertiary hospital

Shi Zhe Gabriel Chia et al. Am J Infect Control. 2020 Jun.

Abstract

Background: We evaluated tuberculosis (TB) acquisition rate and risk factors among health care workers (HCWs) exposed to index TB patients.

Methods: We performed a retrospective cohort study on exposed HCWs from August 2016 to January 2018 at a tertiary hospital in Singapore. Demographic factors and TB exposure episodes per HCW were obtained. A modified Poisson regression model was used to identify factors associated with TB infection.

Results: A total of 32 TB exposure events occurred during the study period. A total of 881 HCWs with 1,536 exposure episodes were screened with QuantiFERON-TB Gold In-tube assay (QFT-GIT) at baseline and 8 weeks. A total of 129 (14.6%) HCWs had positive QFT-TB at baseline, whereas 22 (2.5%) HCWs had QFT-GIT conversion, with a latent TB infection (LTBI) rate of 1.14 cases per 100 exposure episodes per year. Foreign nationality, non-Chinese ethnicity, and age above 40 years were independently associated with baseline LTBI, whereas having >2 TB exposure episodes and working in internal medicine, medical subspecialties, and psychiatry wards were associated with QFT-GIT conversion.

Discussion: The QFT-GIT conversion rate among screened HCWs is low. Foreign HCWs with LTBI likely came from countries with higher TB transmission. Targeted prevention of repeated TB exposures can reduce QFT-GIT conversion.

Conclusions: The study results will guide TB contact tracing protocols in health care institutions.

Keywords: Contact tracing; Tuberculosis.

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