Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-12-01T05:00:47.719Z Has data issue: false hasContentIssue false
  • English
  • Français

A Survey of Latent Tuberculosis Infection Among Laboratory Healthcare Workers in New York City

Published online by Cambridge University Press:  02 January 2015

Elizabeth Garber ,
Pablo San Gabriel ,
Lauren Lambert  and
Lisa Saiman
Elizabeth Garber
Affiliation:
TB study group, Division of Infectious Diseases, Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, New York
Pablo San Gabriel
Affiliation:
TB study group, Division of Infectious Diseases, Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, New York
Lauren Lambert
Affiliation:
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia
Lisa Saiman*
Affiliation:
TB study group, Division of Infectious Diseases, Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, New York
*
Division of Infectious Diseases, Department of Pediatrics, College of Physicians & Surgeons, Columbia University, 630 West 168th Street PH4W-470, New York, NY 10032
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the prevalence of positive tuberculin skin tests (TSTs), incidence of TST conversion, risk factors for positive TSTs, and history of active TB among HCWs in microbiology laboratories in New York City.

Design:

Two-year survey from May 1999 to June 2001.

Setting:

Nineteen microbiology laboratories.

Results:

During the first year, interviews were conducted with 345 laboratory HCWs (mean, 18 HCWs per site; range, 2 to 51) to assess the prevalence of positive TSTs, but 3 (1%) could not recall their result and were excluded from further analyses. The mean age of the remaining 342 HCWs was 48 years; 68% (n = 233) were female, 54% (n = 183) received bacille Calmette-Guérin (BCG) vaccination, and 71% (n = 244) were foreign born. The prevalence of a positive TST was 57% (n = 196), but only 20% (n = 39) of the HCWs received isoniazid. The incidence of TST conversion in the second year of the study was 1% (1 of 108). Multivariate analysis identified age (odds ratio [OR] per year, 1.05; 95% confidence interval [CI95], 1.02–1.08), foreign birth (OR, 3.80; CI95, 1.98–7.28), BCG immunization (OR, 4.89; CI95, 2.72–8.80), and employment in a mycobacteriology laboratory (OR, 2.14; CI95, 1.25–3.68) as risk factors for a positive TST. Only one HCW had been treated for active TB.

Conclusions:

The prevalence of positive TSTs was high among laboratory HCWs, but the TST conversion rate was low. Higher rates of treatment for latent TB infection are desirable.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 11 , November 2003 , pp. 801 - 806
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Reid, DD. Incidence of tuberculosis among workers in medical laboratories. Br Med J 1957;2:10–14.Google Scholar
2. Meredith, S, Watson, JM, Citron, KM, Cockcroft, A, Darbyshire, JH. Are healthcare workers in England and Wales at increased risk of tuberculosis? BMJ 1996;313:522–525.Google Scholar
3. Menzies, D, Fanning, A, Yuan, L, Fitzgerald, M. Tuberculosis among health care workers. N Engl J Med 1995;332:92–98.Google Scholar
4. Grist, NR, Emslie, JAN. Association of clinical pathologists' surveys of infection in British clinical laboratories, 1970-1989. J Clin Pathol 1994;47:391–394.Google Scholar
5. Harrington, JM, Shannon, HS. Incidence of tuberculosis, hepatitis, brucellosis, and shigellosis in British medical laboratory workers. Br Med J 1976;1:759–762.Google Scholar
6. Harries, AD, Nyirenda, TE, Banerjee, A, Boeree, MJ, Salaniponi, FM. Tuberculosis in health care workers in Malawi. Trans R Soc Trop Med Hyg 1999;93:32–35.Google Scholar
7. Usui, T, Yamanaka, K, Nomura, H, Tokudome, S. Elevated risk of tuberculosis by occupation with special reference to health care workers. J Epidemiol 2000;10:1–6.Google Scholar
8. Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities. MMWR 1994;43(RR-13):1–132.Google Scholar
9. Joint Tuberculosis Committee of the British Thoracic Society. Control and prevention of tuberculosis in the United Kingdom: code of practice 2000. Thorax 2000;55:887–901.Google Scholar
10. Centers for Disease Control and Prevention, National Institutes of Health. Agent: Mycobacterium tuberculosis, M. bovis . In: Biosafety in Microbiology and Biomedical Laboratories. Atlanta, GA U.S. Department of Health and Human Services, Public Health Service; 1993:95. DHHS publication no. (CDQ93-8395.Google Scholar
11. Jacobson, JT, Orlob, RB, Clayton, JL. Infections acquired in clinical laboratories in Utah. J Clin Microbiol 1985;21:486–489.Google Scholar
12. Kao, AS, Ashford, DA, McNeil, MM, Warren, NG, Good, RC. Descriptive profile of tuberculin skin testing programs and laboratory-acquired tuberculosis infections in public health laboratories. J Clin Microbiol 1997;35:1847–1851.Google Scholar
13. Ball, LR, Wey, MV. Tuberculosis skin test conversion among health care workers at a military medical center. Mil Med 1997;162:338–343.Google Scholar
14. Bailey, TC, Fraser, VJ, Spitznagel, EL, Dunagan, WC. Risk factors for a positive tuberculin skin test among employees of an urban, midwestern teaching hospital. Ann Intern Med 1995;122:580–585.Google Scholar
15. Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 1999: CDC Surveillance Report. Atlanta, GA: Centers for Disease Control and Prevention; 1999:49.Google Scholar
16. U.S. Census Bureau. 1990 Census Lookup. Washington, DC: U.S. Census Bureau; 1990. Available at homer.ssd.census.gov/cdrom/lookup/996090503. Accessed June 24,2001.Google Scholar
17. Cantwell, MF, McKenna, MT, McCray, E, Onorato, IM. Tuberculosis and race/ethnicity in the United States: impact of socioeconomic status. Am JRespir Crit Care Med 1998;157:1016–1020.Google Scholar
18. Burwen, DR, Seawright, MF. staffTRAK-TB:: software for surveillance of tuberculosis infection in healthcare workers. Infect Control Hosp Epidemiol 1999;20:770–777.Google Scholar
19. Fujiwara, P, Munsiff, S, Harris, H, Frieden, T. Clinical Policies and Protocols, 3rd ed. New York: Bureau of Tuberculosis Control, New York City Department of Health; 1999.Google Scholar
20. Miller, AK, Tepper, A, Sieber, K. Historical risks of tuberculin skin test conversion among non-physician staff at a large urban hospital. Am J Ind Med 2002;42:228–235.Google Scholar
21. Blumberg, HM, Sotir, M, Erwin, M, Bachman, R, Shulman, JA. Risk of house staff tuberculin skin test conversion in an area with a high incidence of tuberculosis. Clin Infect Dis 1998;27:826–833.Google Scholar
22. Soren, K, Saiman, L, Irigoyen, M, Gomez-Duarte, C, Levison, MJ, McMahon, DJ. Evaluation of household contacts of children with positive tuberculin skin tests. Pediatr Infect Dis J 1999;18:946–955.Google Scholar
23. Zahnow, K, Matts, JP, Hillman, D, et al. Rates of tuberculosis infection in healthcare workers providing services to HIV-infected populations. Infect Control Hosp Epidemiol 1998;19:829–835.Google Scholar
24. Schwartzman, K, Loo, V, Pasztor, J, Menzies, D. Tuberculosis infection among health care workers in Montreal. Am J Respir Crit Care Med 1996;154:1006–1012.Google Scholar
25. Jochem, K, Tannenbaum, TN, Menzies, D. Prevalence of tuberculin skin test reactions among prison workers. Can J Public Health 1997;88:202–206.CrossRefGoogle ScholarPubMed
26. Do, AN, Limpakarnjarat, K, Uthaivoravit, W, Zuber, PLF, Korattana, S, Binkin, N. Increased risk of Mycobacterium tuberculosis infection related to the occupational exposures of health care workers in Chiang Rai, Thailand. Int J Tuberc Lung Dis 1999;5:377–381.Google Scholar