Sepkowitz K A, Fella P, Rivera P, Villa N, DeHovitz J
St Clare's Hospital and Health Center, New York City, NY, USA.
Infect Control Hosp Epidemiol. 1995 Jun;16(6):344-7. doi: 10.1086/647123.
To determine the prevalence of tuberculin reactivity among all new employees at a hospital in New York City.
Prospective measurement of purified protein derivative (PPD) status in consecutive new employees at a hospital in New York City from 1991 to 1993. All employees are tested as part of a preemployment physical, assuring complete compliance. Aplisol (Parke-Davis, Morris Plains, NJ) was used in 1991 and 1992, and Tubersol (Connaught, Swiftwater, PA) in 1993. Tests were applied and interpreted by trained employee health personnel.
Of 313 consecutive new employees, comprising all job categories, 40% were PPD positive at time of initial hire, including 20% of US-born and 70% of foreign-born employees. Of 114 persons who had received BCG vaccination, 67% were PPD positive. By multivariate regression analysis, age, BCG vaccination history, and foreign country of birth were independent predictors of a reactive PPD test.
The high prevalence of tuberculin reactivity may reflect high rates of Mycobacterium tuberculosis infection and disease in the community, complicating interpretation of the efficacy of Centers for Disease Control and Prevention (CDC) guidelines to prevent the spread of tuberculosis in healthcare facilities.
确定纽约市一家医院所有新员工中结核菌素反应性的患病率。
对1991年至1993年纽约市一家医院连续入职的新员工进行纯化蛋白衍生物（PPD）状态的前瞻性测量。所有员工作为入职体检的一部分接受检测，确保完全依从性。1991年和1992年使用Aplisol（帕尔克-戴维斯公司，新泽西州莫里斯平），1993年使用结核菌素纯蛋白衍化物（康诺特公司，宾夕法尼亚州斯威夫特沃特）。检测由经过培训的员工健康服务人员进行并解读。
在313名涵盖所有工作类别的连续新员工中，40%在初次入职时PPD呈阳性，其中美国出生的员工占20%，外国出生的员工占70%。在114名接种过卡介苗的人员中，67%的PPD呈阳性。通过多因素回归分析，年龄、卡介苗接种史和出生国是PPD检测呈反应性的独立预测因素。
结核菌素反应性的高患病率可能反映了社区中结核分枝杆菌感染和疾病的高发生率，这使得疾病控制与预防中心（CDC）预防医疗机构内结核病传播指南的效果解读变得复杂。
