韩国一家三级医院中卫生保健工作者潜伏性结核感染的治疗。

Treatment of latent tuberculous infection among health care workers at a tertiary hospital in Korea.

机构信息

Division of Pulmonology, Department of Internal Medicine, Institute of Chest Diseases, Severance Hospital, Yonsei University College of Medicine, Seoul.

Infection Control Office, Severance Hospital, Seoul.

出版信息

Int J Tuberc Lung Dis. 2018 Nov 1;22(11):1336-1343. doi: 10.5588/ijtld.18.0280.

DOI:10.5588/ijtld.18.0280

PMID:30355414

Abstract

OBJECTIVE

To evaluate the acceptance of, adherence to, and outcomes of latent tuberculous infection (LTBI) treatment among health care workers (HCWs).

DESIGN

This was a retrospective study in a tertiary hospital in Korea. From May to August 2017, 2190 HCWs simultaneously underwent a tuberculin skin test (TST) and interferon-gamma release assay (IGRA). LTBI was diagnosed if the TST induration was 10 mm or IGRA results were positive.

RESULTS

Of 2190 HCWs tested, 1006 (45.9%) were diagnosed with LTBI. Of these, 655 (65.1%) HCWs visited out-patient clinics, 234 (35.7%) of whom were advised treatment by physicians. Among these, 120 (51.3%) accepted the physicians' recommendations. In general, HCWs who were older, male and smoked were less likely to visit out-patient clinics. Sixty (50%) HCWs received 3 months of isoniazid plus rifampicin (3HR) and 57 (47.5%) HCWs received 4 months of rifampicin (4R). The proportion of HCWs with 2 side effects (3HR 20% vs. 4R 7.0%, 0.041) and drug stoppage rate (3HR 20% vs. 4R 5.3%, 0.017) were higher in the 3HR group than in the 4R group. Of the 120 HCWs, 78 (65%) completed LTBI treatment.

CONCLUSION

Overall, the acceptance and completion rate for LTBI treatment was not adequate. For effective LTBI management in HCWs, further programmatic strategies are needed.

摘要

目的

评估医护人员（HCWs）潜伏性结核感染（LTBI）治疗的接受度、依从性和结局。

设计

这是韩国一家三级医院的回顾性研究。2017 年 5 月至 8 月，2190 名 HCWs 同时接受结核菌素皮肤试验（TST）和干扰素-γ释放试验（IGRA）。TST 硬结 10mm 或 IGRA 结果阳性诊断为 LTBI。

结果

在 2190 名接受测试的 HCWs 中，有 1006 名（45.9%）被诊断为 LTBI。其中，655 名（65.1%）HCWs 就诊于门诊，其中 234 名（35.7%）医生建议治疗。其中，120 名（51.3%）接受了医生的建议。一般来说，年龄较大、男性和吸烟的 HCWs 不太可能就诊于门诊。60 名（50%）HCWs 接受了 3 个月的异烟肼加利福平（3HR）治疗，57 名（47.5%）HCWs 接受了 4 个月的利福平（4R）治疗。3HR 组有 2 种不良反应（3HR 组 20%比 4R 组 7.0%，0.041）和停药率（3HR 组 20%比 4R 组 5.3%，0.017）高于 4R 组。在 120 名接受治疗的 HCWs 中，有 78 名（65%）完成了 LTBI 治疗。