Barrett-Connor E
JAMA. 1979 Jan 5;241(1):33-8.
The incidence of tuberculosis in physicians was determined by mailed questionnaire. Since 1950 tuberculosis infection preceding entry into medical school has decreased by 73%; at the same time, infection after beginning recent graduates exceeded 1% per year, and age-specific infection rates among physicians were at least twice the US average. Tuberculosis developed in nearly one in ten physicians infected after medical school entry; in two thirds, disease preceded or coincided with recognized tuberculin positivity. No tuberculosis occurred in physicians who used isoniazid chemoprophylaxis, but two thirds of tuberculin-negative physicians did not have annual skin tests, 56% of known recent converters used no chemoprophylaxis, and 25% of those initiating isoniazid prophylaxis did not complete a 12-month course. The Bacillus Calmette-Guérin vaccine recipients had 80% less tuberculosis than unimmunized physicians infected after beginning medical school.
通过邮寄问卷调查确定医生中结核病的发病率。自1950年以来，进入医学院之前的结核感染率下降了73%；与此同时，近期毕业生开始工作后的感染率每年超过1%，医生中的年龄特异性感染率至少是美国平均水平的两倍。医学院入学后感染的医生中，近十分之一患上了结核病；三分之二的病例中，疾病先于或与结核菌素检测呈阳性同时出现。使用异烟肼进行化学预防的医生中未发生结核病，但三分之二结核菌素阴性的医生没有进行年度皮肤测试，56%已知近期结核菌素试验阳转的人未进行化学预防，开始使用异烟肼进行预防的人中有25%未完成12个月的疗程。接种卡介苗的医生比医学院入学后感染但未接种疫苗的医生患结核病的几率低80%。
