纽约市实验室医护人员潜伏性结核感染情况调查。

A survey of latent tuberculosis infection among laboratory healthcare workers in New York City.

作者信息

Garber Elizabeth, San Gabriel Pablo, Lambert Lauren, Saiman Lisa

机构信息

TB study group, Division of Infectious Diseases, Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, New York 10032, USA.

出版信息

Infect Control Hosp Epidemiol. 2003 Nov;24(11):801-6. doi: 10.1086/502140.

DOI:10.1086/502140

PMID:14649766

Abstract

OBJECTIVE

To determine the prevalence of positive tuberculin skin tests (TSTs), incidence of TST conversion, risk factors for positive TSTs, and history of active TB among HCWs in microbiology laboratories in New York City.

DESIGN

Two-year survey from May 1999 to June 2001.

SETTING

Nineteen microbiology laboratories.

RESULTS

During the first year, interviews were conducted with 345 laboratory HCWs (mean, 18 HCWs per site; range, 2 to 51) to assess the prevalence of positive TSTs, but 3 (1%) could not recall their result and were excluded from further analyses. The mean age of the remaining 342 HCWs was 48 years; 68% (n = 233) were female, 54% (n = 183) received bacille Calmette-Guerin (BCG) vaccination, and 71% (n = 244) were foreign born. The prevalence of a positive TST was 57% (n = 196), but only 20% (n = 39) of the HCWs received isoniazid. The incidence of TST conversion in the second year of the study was 1% (1 of 108). Multivariate analysis identified age (odds ratio [OR] per year, 1.05; 95% confidence interval [CI95], 1.02-1.08), foreign birth (OR, 3.80; CI95, 1.98-7.28), BCG immunization (OR, 4.89; CI95, 2.72-8.80), and employment in a mycobacteriology laboratory (OR, 2.14; CI95, 1.25-3.68) as risk factors for a positive TST. Only one HCW had been treated for active TB.

CONCLUSIONS

The prevalence of positive TSTs was high among laboratory HCWs, but the TST conversion rate was low. Higher rates of treatment for latent TB infection are desirable.

摘要

目的

确定纽约市微生物实验室医护人员结核菌素皮肤试验（TST）阳性的患病率、TST 转换的发生率、TST 阳性的危险因素以及活动性结核病病史。

设计

1999 年 5 月至 2001 年 6 月的两年期调查。

地点

19 个微生物实验室。

结果

在第一年，对 345 名实验室医护人员（平均每个地点 18 名医护人员；范围为 2 至 51 名）进行了访谈，以评估 TST 阳性的患病率，但有 3 人（1%）记不起他们的结果，被排除在进一步分析之外。其余 342 名医护人员的平均年龄为 48 岁；68%（n = 233）为女性，54%（n = 183）接种过卡介苗（BCG），71%（n = 244）出生在国外。TST 阳性的患病率为 57%（n = 196），但只有 20%（n = 39）的医护人员接受了异烟肼治疗。研究第二年 TST 转换的发生率为 1%（108 人中的 1 人）。多变量分析确定年龄（每年的优势比[OR]为 1.05；95%置信区间[CI95]为 1.02 - 1.08）、出生在国外（OR 为 3.80；CI95 为 1.98 - 7.28）、BCG 免疫接种（OR 为 4.89；CI95 为 2.72 - 8.80）以及在分枝杆菌学实验室工作（OR 为 2.14；CI95 为 1.25 - 3.68）是 TST 阳性的危险因素。只有一名医护人员接受过活动性结核病治疗。