Geiseler P J, Nelson K E, Crispen R G, Moses V K
Am Rev Respir Dis. 1986 May;133(5):773-8.
We evaluated the occurrence of active tuberculosis in 4,575 physicians who graduated between 1938 and 1981 from the same medical school. There were 66 cases. Fifteen (23%) cases were detected after 1970 including 4 diagnosed in 1981. For most years, the incidence of tuberculosis was higher in physicians than in the general population. Forty-eight (73%) patients were between 25 and 34 yr of age at the time of diagnosis. Two thirds of all cases occurred within 6 yr of graduation, even in graduates since 1970. The risk of tuberculosis was 140 per 100,000 persons-years within 6 yr of graduation. Sixty-three percent of initially tuberculin-negative medical students who subsequently had active tuberculosis converted their tuberculin reaction during medical school or clinical training. Recipients of BCG vaccine had 40% less tuberculosis than unimmunized, initially tuberculin-negative, physicians. Health authorities should be cognizant of the continuing risk of tuberculosis in medical students and physicians.
我们评估了1938年至1981年间毕业于同一所医学院的4575名医生中活动性肺结核的发病情况。共有66例病例。其中15例（23%）在1970年后被确诊，包括1981年诊断的4例。在大多数年份里，医生中肺结核的发病率高于普通人群。48例（73%）患者在诊断时年龄在25至34岁之间。所有病例的三分之二发生在毕业6年内，即使是1970年以后毕业的学生。毕业6年内肺结核的发病风险为每10万人年140例。最初结核菌素阴性的医学生中，后来发生活动性肺结核的人有63%在医学院或临床培训期间结核菌素反应发生了转变。接种卡介苗的医生患肺结核的几率比未接种、最初结核菌素阴性的医生低40%。卫生当局应认识到医学生和医生患肺结核的持续风险。
