Keywords
Latent tuberculosis; contact screening; Quantiferon; occupational health
Abstract
OBJECTIVE. The latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation by Mycobacterium Tuberculosis antigens without clinical manifestation: the healthcare workers (HCWs) have a higher exposure risk so prevention is an important challenge for occupational medicine. The aim of our study is to evaluate the prevalence of LTBI among HCWs of the Foundation Policlinic “Tor Vergata”.
METHODS. This is a retrospective study conducted by analyzing the clinical records of 825 HCWs of the PTV, from January 1st to December 31th 2016. To evaluate the TB infection we used the Quantiferon TB Gold interferon-gamma release assay.
RESULTS. Our study underline the low prevalence of LTBI in the Italian healthcare workers.
CONCLUSION. Although the LTBI status is not contagious, the diagnosis and the safety strategies require specific clinical and preventive considerations.
References
1. World Health Organization. Global Tuberculosis Report. 2018
2. Centers for Disease Control and Prevention. Guidelines for the investigation of contacts of persons with infectious tuberculosis: recommendations from the National Tuberculosis Controllers Association and CDC. MMWR 2005; 54(No. RR-17): 1-47
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11. Uden L, Barber E, Ford N, Cooke GS. Risk of Tuberculosis Infection and Disease for Health Care Workers: An Updated Meta-Analysis. Open Forum Infect Dis. 2017 Aug 29;4(3):ofx137. doi: 10.1093/ofid/ofx137. E Collection 2017 Summer
12. Lamberti M, Muoio MR, Westermann C, Nienhaus A, Arnese A, Ribeiro Sobrinho AP, Di Giuseppe G, Garzillo EM, Crispino V, Coppola N, De Rosa A. Prevalence and associated risk factors of latent tuberculosis infection among undergraduate and postgraduate dental students: A retrospective study. Arch Environ Occup Health. 2016 Mar 28:1-7
13. Centers for Disease Control and Prevention. Updated guidelines for using interferon-gamma release assays to detect Mycobacterium tuberculosis infection — United States. MMWR 59(RR05)
14. Coppeta L, Baldi S, Somma G, Tursi E, Policardo S, Balbi O, Lieto P, Pietroiusti A, Magrini A. QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study. Epidemiology Biostatistics and Public Health. Epub 2019
15. Magrini A, Coppeta L, Somma G, Neri A, Gentili S, Fiocco G, Pietroiusti A. Risk of tuberculosis in healthcare workers: risk assessment and medical surveillance. Ig Sanità Pubbl. 2016 Mar-Apr;72(2):137-43
16. Verrall AJ, Netea MG, Alisjahbana B, Hill PC, van Crevel R. Early clearance of Mycobacterium tuberculosis: a new frontier in prevention. Immunology. 2014 Apr;141(4):506-13. doi: 10.1111/imm.12223
17. Nardell EA, Wallis RS. Here today gone tomorrow: the case for transient acute tuberculosis infection. Am J Respir Crit Care Med. 2006 Oct 1;174(7):734-5
2. Centers for Disease Control and Prevention. Guidelines for the investigation of contacts of persons with infectious tuberculosis: recommendations from the National Tuberculosis Controllers Association and CDC. MMWR 2005; 54(No. RR-17): 1-47
3. Istituto Superiore di Sanità. Tubercolosi Aspetti epidemiologici: dati generali. Antonietta Filia. http://www.epicentro.iss.it/problemi/Tubercolosi/epid.asp
4. Centers for Disease Control and Prevention. CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health - Care Settings, 2005 MMWR 2005; 54 (No. RR-17, 1-141)
5. World Health Organization. WHO policy on TB infection control in health-care facilities, congregate settings and households — 2009 - http://whqlibdoc.who.int/publications/2009/9789241598323_eng.pdf
6. Decreto legislativo 9 aprile 2008, n. 81 “Attuazione dell’articolo 1 della legge 3 agosto 2007, n. 123, in materia di tutela della salute e della sicurezza nei luoghi di lavoro”
7. Conferenza permanente per i rapporti tra lo Stato, le Regioni e le Province Autonome di Trento e Bolzano – Provvedimento 17 dicembre 1998 – Linee Guida per il controllo della malattia tubercolare, su proposta del Ministro della Sanità, ai sensi dell’art. 115, comma 1, lettera b), del decreto legislativo 31 marzo 1998, n. 112
8. Ministero del Lavoro della Salute e delle Politiche Sociali. Aggiornamento delle raccomandazioni per le attività di controllo della tubercolosi in Italia. Anno 2013. http://www.salute.gov.it/imgs/C_17_pubblicazioni_1221_allegato.pdf
9. Ministero del Lavoro della Salute e delle Politiche Sociali. Prevenzione della tubercolosi negli operatori sanitari e soggetti ad essi equiparati. Approvato come Accordo nella Conferenza Stato-Regioni-Province Autonome del 7 febbraio 2013
10. Zwerling A1, van den Hof S, Scholten J, Cobelens F, Menzies D, Pai M. Interferon-gamma release assays for tuberculosis screening of healthcare workers: a systematic review. Thorax. 2012 Jan;67(1):62-70. doi: 10.1136/thx.2010.143180
11. Uden L, Barber E, Ford N, Cooke GS. Risk of Tuberculosis Infection and Disease for Health Care Workers: An Updated Meta-Analysis. Open Forum Infect Dis. 2017 Aug 29;4(3):ofx137. doi: 10.1093/ofid/ofx137. E Collection 2017 Summer
12. Lamberti M, Muoio MR, Westermann C, Nienhaus A, Arnese A, Ribeiro Sobrinho AP, Di Giuseppe G, Garzillo EM, Crispino V, Coppola N, De Rosa A. Prevalence and associated risk factors of latent tuberculosis infection among undergraduate and postgraduate dental students: A retrospective study. Arch Environ Occup Health. 2016 Mar 28:1-7
13. Centers for Disease Control and Prevention. Updated guidelines for using interferon-gamma release assays to detect Mycobacterium tuberculosis infection — United States. MMWR 59(RR05)
14. Coppeta L, Baldi S, Somma G, Tursi E, Policardo S, Balbi O, Lieto P, Pietroiusti A, Magrini A. QuantiFERON-TB Gold Plus evaluation for latent tuberculosis infection among Italian healthcare workers: a cross-sectional study. Epidemiology Biostatistics and Public Health. Epub 2019
15. Magrini A, Coppeta L, Somma G, Neri A, Gentili S, Fiocco G, Pietroiusti A. Risk of tuberculosis in healthcare workers: risk assessment and medical surveillance. Ig Sanità Pubbl. 2016 Mar-Apr;72(2):137-43
16. Verrall AJ, Netea MG, Alisjahbana B, Hill PC, van Crevel R. Early clearance of Mycobacterium tuberculosis: a new frontier in prevention. Immunology. 2014 Apr;141(4):506-13. doi: 10.1111/imm.12223
17. Nardell EA, Wallis RS. Here today gone tomorrow: the case for transient acute tuberculosis infection. Am J Respir Crit Care Med. 2006 Oct 1;174(7):734-5