Placidi D, Tonozzi B, Alessio L, Porru S
Scuola di Specializzazione in Medicina del Lavoro, Università degli Studi di Brescia.
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):409-11.
To summarize the evidence on the Tuberculin Skin Test (TST) survey among healthcare workers (HCWs) in hospital, in the last decade.
A systematic search was conducted in PubMed and in the Proceedings of the congresses of the Italian Society of Occupational Health and Industrial Hygiene (SIMLII); researches conducted in areas with medium-high incidence of Tuberculosis were excluded.
25 publications were identified. The compliance of HCWs to TST surveys ranged from 80 to 100%, the incidence of TST-conversion from 0.07 to 3.7% and the prevalence of positive TST from 5,7 to 57%. TST-conversion and positive TST were significantly associated to BCG vaccination and foreign-born. Most studies found an association between TST-conversion and occupational exposure in certain location (emergency facilities, internal medicine, infectious diseases, intensive care units, pathology, microbiology) and occupational categories (nurses, laboratory technicians). In some studies, period of hospital employment do not increased TST conversion rate.
Positive TST and TST conversion rate seem to be associated with occupational exposure to Mycobacterium Tuberculosis in hospital, considering non-occupational factors. Evidence from literature seemed to support the use of TST in the tuberculosis screening programme of HCWs in hospital.
总结过去十年间医院医护人员结核菌素皮肤试验（TST）调查的相关证据。
在PubMed以及意大利职业健康与工业卫生协会（SIMLII）大会论文集上进行系统检索；排除在结核病中高发病率地区开展的研究。
共识别出25篇出版物。医护人员参与TST调查的依从率在80%至100%之间，TST阳转率在0.07%至3.7%之间，TST阳性率在5.7%至57%之间。TST阳转和TST阳性与卡介苗接种及出生在国外显著相关。多数研究发现TST阳转与在某些场所（急诊设施、内科、传染病科、重症监护病房、病理科、微生物科）的职业暴露以及职业类别（护士、实验室技术员）之间存在关联。在一些研究中，医院工作年限并未提高TST阳转率。
考虑到非职业因素，TST阳性和TST阳转率似乎与医院中职业性接触结核分枝杆菌有关。文献证据似乎支持在医院医护人员结核病筛查项目中使用TST。
