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Risk of latent TB infection in individuals employed in the healthcare sector in Germany: a multicentre prevalence study.

Schablon A, Harling M, Diel R, Nienhaus A - BMC Infect. Dis. (2010)

Bottom Line: A positive IGRA was found in 9.9% of the healthcare workers (HCWs).Analysed by occupational group, the highest prevalence was found in administration staff and ancillary nursing staff (17.4% and 16.7%).We found no positive IGRA results among trainees in the healthcare sector.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Department of Occupational Health Research, Pappelallee 35-37, Hamburg, Germany. anja.schablon@bgw-online.de

ABSTRACT

Background: Healthcare workers are still recognised as a high-risk group for latent TB infection (LTBI). Therefore, the screening of people employed in the healthcare sector for active and LTBI is fundamental to infection control programmes in German hospitals. It was the aim of the study to determine the prevalence and putative risk factors of LTBI.

Methods: We tested 2028 employees in the healthcare sector with the QuantiFERON-Gold In-tube (QFT-IT) test between December 2005 and May 2009, either in the course of contact tracing or in serial testing of TB high-risk groups following German OSH legislation.

Results: A positive IGRA was found in 9.9% of the healthcare workers (HCWs). Nurses and physicians showed similar prevalence rates (9.7% to 9.6%). Analysed by occupational group, the highest prevalence was found in administration staff and ancillary nursing staff (17.4% and 16.7%). None of the individuals in the trainee group showed a positive IGRA result. In the different workplaces the observed prevalence was 14.7% in administration, 12.0% in geriatric care, 14.2% in technicians (radiology, laboratory and pathology), 6.5% in admission ward staff and 8.3% in the staff of pulmonary/infectious disease wards. Putative risk factors for LTBI were age (>55 years: OR14.7, 95% CI 5.1-42.1), being foreign-born (OR 1.99, 95% CI 1.4-2.8), TB in the individual's own history (OR 4.96, 95% CI 1.99-12.3) and previous positive TST results (OR 3.5, 95% CI 2.4-4.98). We observed no statistically significant association with gender, BCG vaccination, workplace or profession.

Conclusion: The prevalence of LTBI in low-incidence countries depends on age. We found no positive IGRA results among trainees in the healthcare sector. Incidence studies are needed to assess the infection risk. Pre-employment screening might be helpful in this endeavour.

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Description of the study population depending on TST and IGRA.
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Figure 1: Description of the study population depending on TST and IGRA.

Mentions: A positive QFT-IT result was observed in 198 (9.9%) participants and 480 (24.0%) participants reported a positive TST (Table 1). Of the 480 participants with a positive previous TST, 94 (19.6%) were confirmed by the IGRA Previous TST results were mostly estimated with the old multipuncture test (n = 352). Out of 507 participants with no TST in their medical history, 48 persons (9.5%) were positive by QFT-IT (Figure 1).


Risk of latent TB infection in individuals employed in the healthcare sector in Germany: a multicentre prevalence study.

Schablon A, Harling M, Diel R, Nienhaus A - BMC Infect. Dis. (2010)

Description of the study population depending on TST and IGRA.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2877045&req=5

Figure 1: Description of the study population depending on TST and IGRA.
Mentions: A positive QFT-IT result was observed in 198 (9.9%) participants and 480 (24.0%) participants reported a positive TST (Table 1). Of the 480 participants with a positive previous TST, 94 (19.6%) were confirmed by the IGRA Previous TST results were mostly estimated with the old multipuncture test (n = 352). Out of 507 participants with no TST in their medical history, 48 persons (9.5%) were positive by QFT-IT (Figure 1).

Bottom Line: A positive IGRA was found in 9.9% of the healthcare workers (HCWs).Analysed by occupational group, the highest prevalence was found in administration staff and ancillary nursing staff (17.4% and 16.7%).We found no positive IGRA results among trainees in the healthcare sector.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Department of Occupational Health Research, Pappelallee 35-37, Hamburg, Germany. anja.schablon@bgw-online.de

ABSTRACT

Background: Healthcare workers are still recognised as a high-risk group for latent TB infection (LTBI). Therefore, the screening of people employed in the healthcare sector for active and LTBI is fundamental to infection control programmes in German hospitals. It was the aim of the study to determine the prevalence and putative risk factors of LTBI.

Methods: We tested 2028 employees in the healthcare sector with the QuantiFERON-Gold In-tube (QFT-IT) test between December 2005 and May 2009, either in the course of contact tracing or in serial testing of TB high-risk groups following German OSH legislation.

Results: A positive IGRA was found in 9.9% of the healthcare workers (HCWs). Nurses and physicians showed similar prevalence rates (9.7% to 9.6%). Analysed by occupational group, the highest prevalence was found in administration staff and ancillary nursing staff (17.4% and 16.7%). None of the individuals in the trainee group showed a positive IGRA result. In the different workplaces the observed prevalence was 14.7% in administration, 12.0% in geriatric care, 14.2% in technicians (radiology, laboratory and pathology), 6.5% in admission ward staff and 8.3% in the staff of pulmonary/infectious disease wards. Putative risk factors for LTBI were age (>55 years: OR14.7, 95% CI 5.1-42.1), being foreign-born (OR 1.99, 95% CI 1.4-2.8), TB in the individual's own history (OR 4.96, 95% CI 1.99-12.3) and previous positive TST results (OR 3.5, 95% CI 2.4-4.98). We observed no statistically significant association with gender, BCG vaccination, workplace or profession.

Conclusion: The prevalence of LTBI in low-incidence countries depends on age. We found no positive IGRA results among trainees in the healthcare sector. Incidence studies are needed to assess the infection risk. Pre-employment screening might be helpful in this endeavour.

Show MeSH
Related in: MedlinePlus