Elmer A, Kortsik C S, Pies U, Koelbel C, Albrecht P
Pneumologische Abteilung, St. Hildegardis-Krankenhaus, Mainz.
Pneumologie. 2000 Oct;54(10):425-30. doi: 10.1055/s-2000-7686.
Detection of latent tuberculosis infection is an important step in the control of tuberculosis. The tuberculin skin test is the only proven method for identifying tuberculosis infection in patients who do not have tuberculosis disease. The prevalence of tuberculosis infection among hospitalized patients in a pneumological department of an inner-city hospital was evaluated, using the intradermal tuberculin skin test (Mantoux technique). Interpretation of the Mantoux test was based on the size of induration in millimeters and the individual risk profile of the patients, according to the guidelines of the American Thoracic Society and the Centers for Disease Control, revised in 1989. Of 697 tested patients, 252 showed test results consistent with tuberculosis infection (36.2%). 55 of these 697 patients had active tuberculosis disease or a prior history of tuberculosis (7.9%). A positive tuberculin skin test was found in 197 of 642 patients (30.7%) with a diagnosis different from tuberculosis (COPD, pneumonia, cancer and others). In our study, the sensitivity of the tuberculin skin test for active tuberculosis infection was 95%. The present study revealed a high prevalence of tuberculosis infection among hospitalized patients in a pneumological department. Further studies are needed to assess the usefulness of routine tuberculin skin testing in hospitalized populations.
潜伏性结核感染的检测是结核病控制中的重要一步。结核菌素皮肤试验是在无结核病的患者中识别结核感染的唯一经证实的方法。采用皮内结核菌素皮肤试验(曼托试验技术)对一家市中心医院呼吸内科住院患者的结核感染患病率进行了评估。根据美国胸科学会和疾病控制中心于1989年修订的指南,曼托试验的解读基于硬结的大小(以毫米为单位)和患者的个体风险状况。在697名接受检测的患者中,252名的检测结果符合结核感染(36.2%)。这697名患者中有55名患有活动性结核病或有结核病史(7.9%)。在642名诊断为非结核病(慢性阻塞性肺疾病、肺炎、癌症等)的患者中,197名(30.7%)结核菌素皮肤试验呈阳性。在我们的研究中,结核菌素皮肤试验对活动性结核感染的敏感性为95%。本研究揭示了一家呼吸内科住院患者中结核感染的高患病率。需要进一步研究以评估住院人群中常规结核菌素皮肤试验的效用。