MMWR Morb Mortal Wkly Rep. 2019 May 17;68(19):439-443. doi: 10.15585/mmwr.mm6819a3.
The 2005 CDC guidelines for preventing Mycobacterium tuberculosis transmission in health care settings include recommendations for baseline tuberculosis (TB) screening of all U.S. health care personnel and annual testing for health care personnel working in medium-risk settings or settings with potential for ongoing transmission (1). Using evidence from a systematic review conducted by a National Tuberculosis Controllers Association (NTCA)-CDC work group, and following methods adapted from the Guide to Community Preventive Services (2,3), the 2005 CDC recommendations for testing U.S. health care personnel have been updated and now include 1) TB screening with an individual risk assessment and symptom evaluation at baseline (preplacement); 2) TB testing with an interferon-gamma release assay (IGRA) or a tuberculin skin test (TST) for persons without documented prior TB disease or latent TB infection (LTBI); 3) no routine serial TB testing at any interval after baseline in the absence of a known exposure or ongoing transmission; 4) encouragement of treatment for all health care personnel with untreated LTBI, unless treatment is contraindicated; 5) annual symptom screening for health care personnel with untreated LTBI; and 6) annual TB education of all health care personnel.
2005 年美国疾病预防控制中心（CDC）针对医疗机构中结核分枝杆菌传播的预防指南包括对所有美国卫生保健人员进行基础结核病（TB）筛查的建议，以及对在中危环境或有持续传播可能的环境中工作的卫生保健人员进行年度检测的建议（1）。该指南参考了美国国家结核病控制协会（NTCA）-CDC 工作组进行的系统评价中的证据，并遵循社区预防服务指南（2,3）中的方法，更新了 2005 年美国疾病预防控制中心对卫生保健人员检测的建议，现在包括：1）在入职前（基础期）进行个人风险评估和症状评估的 TB 筛查；2）对没有记录的既往 TB 疾病或潜伏性 TB 感染（LTBI）的人员进行干扰素-γ释放试验（IGRA）或结核菌素皮肤试验（TST）的 TB 检测；3）在没有已知暴露或持续传播的情况下，在基础期后任何时间间隔内不进行常规连续 TB 检测；4）鼓励对所有未经治疗的 LTBI 卫生保健人员进行治疗，除非治疗禁忌；5）对未经治疗的 LTBI 卫生保健人员进行年度症状筛查；6）对所有卫生保健人员进行年度 TB 教育。
