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Tuberculosis transmission from healthcare workers to patients and co-workers: a systematic literature review and meta-analysis.

Schepisi MS, Sotgiu G, Contini S, Puro V, Ippolito G, Girardi E - PLoS ONE (2015)

Bottom Line: The quantitative analysis of 28 individual reports showed that combined proportions of active TB among exposed individuals were: 0.11% (95% CI 0.04-0.21) for infants, 0.38% (95% CI 0.01-1.60) for children, 0.09% (95% CI 0.02-0.22) for adults and 0.00% (95% CI 0.00-0.38) for HCWs.Combined proportions of individuals who acquired TB infection were: 0.57% (95% CI 7.28E-03 - 2.02) for infants, 0.9% (95% CI 0.40-1.60) for children, 4.32% (95% CI 1.43-8.67) for adults and 2.62% (95% CI 1.05-4.88) for HCWs.To provide a firm evidence base for the screening strategies, more and better information is needed on the infectivity of the source cases, the actual exposure level of screened contacts, and the environmental characteristics of the healthcare setting.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Preclinical Research, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy.

ABSTRACT
Healthcare workers (HCWs) are at risk of becoming infected with tuberculosis (TB), and potentially of being infectious themselves when they are ill. To assess the magnitude of healthcare-associated TB (HCA-TB) transmission from HCWs to patients and colleagues, we searched three electronic databases up to February 2014 to select primary studies on HCA-TB incidents in which a HCW was the index case and possibly exposed patients and co-workers were screened.We identified 34 studies out of 2,714 citations. In 29 individual investigations, active TB was diagnosed in 3/6,080 (0.05%) infants, 18/3,167 (0.57%) children, 1/3,600 (0.03%) adult patients and 0/2,407 HCWs. The quantitative analysis of 28 individual reports showed that combined proportions of active TB among exposed individuals were: 0.11% (95% CI 0.04-0.21) for infants, 0.38% (95% CI 0.01-1.60) for children, 0.09% (95% CI 0.02-0.22) for adults and 0.00% (95% CI 0.00-0.38) for HCWs. Combined proportions of individuals who acquired TB infection were: 0.57% (95% CI 7.28E-03 - 2.02) for infants, 0.9% (95% CI 0.40-1.60) for children, 4.32% (95% CI 1.43-8.67) for adults and 2.62% (95% CI 1.05-4.88) for HCWs. The risk of TB transmission from HCWs appears to be lower than that recorded in other settings or in the healthcare setting when the index case is not a HCW. To provide a firm evidence base for the screening strategies, more and better information is needed on the infectivity of the source cases, the actual exposure level of screened contacts, and the environmental characteristics of the healthcare setting.

No MeSH data available.


Related in: MedlinePlus

PRISMA 2009 Flow Diagram.Flowchart depicting methods for article inclusion and exclusion. Abbreviations: MTB = Mycobacterium tuberculosis; TB = Tuberculosis; LTBI = Latent Tuberculosis Infection; HCWs = Health Care Workers
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pone.0121639.g001: PRISMA 2009 Flow Diagram.Flowchart depicting methods for article inclusion and exclusion. Abbreviations: MTB = Mycobacterium tuberculosis; TB = Tuberculosis; LTBI = Latent Tuberculosis Infection; HCWs = Health Care Workers

Mentions: Our literature database search yielded 2,714 records and after considering their references and citing articles, we finally included 34 original articles resulting from the selection process described in Fig 1. A complete list of excluded articles with reasons for exclusion is available upon request from the authors.


Tuberculosis transmission from healthcare workers to patients and co-workers: a systematic literature review and meta-analysis.

Schepisi MS, Sotgiu G, Contini S, Puro V, Ippolito G, Girardi E - PLoS ONE (2015)

PRISMA 2009 Flow Diagram.Flowchart depicting methods for article inclusion and exclusion. Abbreviations: MTB = Mycobacterium tuberculosis; TB = Tuberculosis; LTBI = Latent Tuberculosis Infection; HCWs = Health Care Workers
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383623&req=5

pone.0121639.g001: PRISMA 2009 Flow Diagram.Flowchart depicting methods for article inclusion and exclusion. Abbreviations: MTB = Mycobacterium tuberculosis; TB = Tuberculosis; LTBI = Latent Tuberculosis Infection; HCWs = Health Care Workers
Mentions: Our literature database search yielded 2,714 records and after considering their references and citing articles, we finally included 34 original articles resulting from the selection process described in Fig 1. A complete list of excluded articles with reasons for exclusion is available upon request from the authors.

Bottom Line: The quantitative analysis of 28 individual reports showed that combined proportions of active TB among exposed individuals were: 0.11% (95% CI 0.04-0.21) for infants, 0.38% (95% CI 0.01-1.60) for children, 0.09% (95% CI 0.02-0.22) for adults and 0.00% (95% CI 0.00-0.38) for HCWs.Combined proportions of individuals who acquired TB infection were: 0.57% (95% CI 7.28E-03 - 2.02) for infants, 0.9% (95% CI 0.40-1.60) for children, 4.32% (95% CI 1.43-8.67) for adults and 2.62% (95% CI 1.05-4.88) for HCWs.To provide a firm evidence base for the screening strategies, more and better information is needed on the infectivity of the source cases, the actual exposure level of screened contacts, and the environmental characteristics of the healthcare setting.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Preclinical Research, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy.

ABSTRACT
Healthcare workers (HCWs) are at risk of becoming infected with tuberculosis (TB), and potentially of being infectious themselves when they are ill. To assess the magnitude of healthcare-associated TB (HCA-TB) transmission from HCWs to patients and colleagues, we searched three electronic databases up to February 2014 to select primary studies on HCA-TB incidents in which a HCW was the index case and possibly exposed patients and co-workers were screened.We identified 34 studies out of 2,714 citations. In 29 individual investigations, active TB was diagnosed in 3/6,080 (0.05%) infants, 18/3,167 (0.57%) children, 1/3,600 (0.03%) adult patients and 0/2,407 HCWs. The quantitative analysis of 28 individual reports showed that combined proportions of active TB among exposed individuals were: 0.11% (95% CI 0.04-0.21) for infants, 0.38% (95% CI 0.01-1.60) for children, 0.09% (95% CI 0.02-0.22) for adults and 0.00% (95% CI 0.00-0.38) for HCWs. Combined proportions of individuals who acquired TB infection were: 0.57% (95% CI 7.28E-03 - 2.02) for infants, 0.9% (95% CI 0.40-1.60) for children, 4.32% (95% CI 1.43-8.67) for adults and 2.62% (95% CI 1.05-4.88) for HCWs. The risk of TB transmission from HCWs appears to be lower than that recorded in other settings or in the healthcare setting when the index case is not a HCW. To provide a firm evidence base for the screening strategies, more and better information is needed on the infectivity of the source cases, the actual exposure level of screened contacts, and the environmental characteristics of the healthcare setting.

No MeSH data available.


Related in: MedlinePlus