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. 2020 Jul 17;15(7):e0235986.
doi: 10.1371/journal.pone.0235986. eCollection 2020.

Serial testing of health care workers for tuberculosis infection: A prospective cohort study

Irma Casas  1   2 , Maria Esteve  1   2 , Rosa Guerola  1 , Irene Latorre  2   3   4 , Raquel Villar-Hernández  2   3   4 , Guillermo Mena  1   2 , Cristina Prat-Aymerich  2   3   4   5 , Joan Matllo  6 , Jose Dominguez  2   3   4
Affiliations

Serial testing of health care workers for tuberculosis infection: A prospective cohort study

Irma Casas et al. PLoS One. .

Abstract

Health Care Workers (HCW) may have an occupational risk of latent tuberculosis infection (LTBI) and TB disease. The objective of this study was to evaluate the performance of the 2-step strategy: tuberculin skin test (TST) followed by confirmation with Interferon (IFN)-γ- release assays (IGRAs) in HCW. A secondary objective was to determine the factors related to conversions and reversions. HCW at risk of occupational exposure who attended the Occupational Department of the Hospital Germans Trias i Pujol were included during the study period (2013-2016). All professionals testing negative for LTBI were included in a cohort study. These workers were followed up with the administration of a TST and an IGRA quantification at least one year after inclusion in the study. Workers with positive TST, regardless of the results of the IGRA tests, were followed-up with an IGRA. 255 workers were enrolled in the study and 108 workers from the same cohort were followed up. During the follow-up period, seven workers presented TST test conversion. One of these conversions was also confirmed by an IGRA test. There were 2 conversions of cases only testing positive with the IGRA. There have been only 2 reversions of cases testing negative with the IGRA. In this study, not all TST conversions were confirmed when using the IGRA test, which highlights the importance of the 2-step strategy. We have detected a low number of conversions and reversions. Our conclusions should be confirmed in studies with a longer follow-up time.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Design and description of the results of the serial tests of the study.
Fig 2
Fig 2. Quantification of the IGRA according to TST result.
See this image and copyright information in PMC

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