Ciaschetti A, Franchi A, Richeldi L, Rumpianesi F, Meacci M, Valente A, Franco G
Cattedra e Scuola di Specializzazione in Medicina del Lavoro, Università degli Studi di Modena e Reggio Emilia, Italy,
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):406-7.
Recent guidelines (MMWR 2005) recommend the use of QuantiFERON-TB (QFT-TB) as an alternative to the tuberculin skin test (TST) for the screening of latent tuberculosis infection (LTBI) in health care workers (HCWs).
590 HCWs were screened for LTBI by TST and QFT-TB. Results were compared with risk factors for LTBI, determined by questionnaires.
Both tests were significantly associated with non-Italian nationality [TCT (OR = 9.17), QFT-TB (OR = 3.65)], age > or = 45 years old [TCT (OR = 1.81), QFT-TB (OR = 2.36)], history of household contacts [TCT (OR = 2.65), QFT-TB (OR = 3.37], occupational exposure to tuberculosis (TB) patients [TCT (OR = 2.14), QFT-TB (OR = 1.93)]. 55 cases were discordant (28 QFT-TB-negatives/TCT-positives; 27 QFT-TB-positives/TCT-negatives). Both tests were not associated with workplace risk factors or TB risk level assessed in different hospital units.
In HCWs employed in a low TB incidence area both QFT-TB and TCT were more associated with non occupational risk factors (nationality, age, household contacts) than with main determinants of workplace risk for LTBI.
近期指南（《发病率与死亡率周报》，2005年）推荐使用结核感染快速检测（QFT-TB）作为结核菌素皮肤试验（TST）的替代方法，用于筛查医护人员（HCWs）的潜伏性结核感染（LTBI）。
采用TST和QFT-TB对590名医护人员进行LTBI筛查。将结果与通过问卷调查确定的LTBI风险因素进行比较。
两种检测均与非意大利国籍显著相关[TCT（比值比=9.17），QFT-TB（比值比=3.65）]、年龄≥45岁[TCT（比值比=1.81），QFT-TB（比值比=2.36）]、家庭接触史[TCT（比值比=2.65），QFT-TB（比值比=3.37）]、职业性接触结核病（TB）患者[TCT（比值比=2.14），QFT-TB（比值比=1.93）]。55例结果不一致（28例QFT-TB阴性/TCT阳性；27例QFT-TB阳性/TCT阴性）。两种检测均与不同医院科室评估的工作场所风险因素或TB风险水平无关。
在结核病发病率较低地区工作的医护人员中，QFT-TB和TCT与非职业风险因素（国籍、年龄、家庭接触史）的相关性高于与LTBI工作场所风险主要决定因素的相关性。
