[Experience of extensive screening of Mycobacterium tuberculosis transmission to patients exposed to a pediatrician].
OBJECTIVE
This study reports the investigation of the patients of a private-practice pediatrician with smear-positive tuberculosis.


METHODS
One thousand six hundred and fifty-six children were screened. Two screenings (T0 and 3 months later) were proposed, with a tuberculin skin testing (TST) and a chest radiograph. A T-cell-based assay was performed on children with intermediary values.


RESULTS
No active tuberculosis was identified. Skin tests on 1171 children (83.1%) were negative on screenings. Nearly all chest radiographs were normal (96.9% on the initial screening, 98.8% on the 2nd). T-cell-based assays were negative. Of the 803 children younger than 2 years of age, 583 (72.6%) were directed to prophylaxis, children older than 2 years of age were treated based on the 2nd screening as latent tuberculosis infection. Sixty non serious side effects were reported 54 children, most of were digestive. Prophylaxis was stopped in 52 cases, in 22 cases a side effect. Compliance to the 2 visits was good (87.7%).


CONCLUSIONS
This investigation concerning a large number of children confirms limited transmission of Mycobacterium tuberculosis from a pediatrician with smear-positive tuberculosis to pediatric outpatients. Coordination screening by the tuberculosis control section is essential. The T-cell-based assay could better correlate the contamination risk to the intensity and the length of exposure compared with TST and could avoid screening a large number of patients.
Berlioz
M
M
Service de pédiatrie, hôpital de l'Archet, CHU de Nice, 151, route de Saint-Antoine de Ginestière, 06202 Nice cedex 3, France. berlioz.m@chu-nice.fr
Del Mar Corcostegui
M
M
Dalfin
M
M
Saos
J
J
Albertini
M
M
D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D017757:Infectious Disease Transmission, Professional-to-Patient; D008875:Middle Aged; D010372:Pediatrics; D014376:Tuberculosis / Q000175:diagnosis* / Q000635:transmission*
Expérience du dépistage à large échelle de la transmission de Mycobacterium tuberculosis par un pédiatre libéral à ses patients.