title: Tuberculosis screening programme using the QuantiFERON-TB Gold test and chest computed tomography for healthcare workers accidentally exposed to patients with tuberculosis.
abstract: Healthcare workers (HCWs) have an increased incidence of tuberculosis (TB). Periodic and as-needed screenings of HCWs exposed to patients with TB are important. We integrated chest computed tomography (CT) and the QuantiFERON-TB Gold (QFT-G) test into our TB screening programme for HCWs. First, contacts were tested using the QFT-G test. Those positive for the QFT-G test were investigated by CT and classified as having active, latent (LTBI), or old TB. Between April 2005 and April 2010, 11 patients who had not been diagnosed with active TB on admission were found to have the disease. A total of 512 close or high risk contacts were identified, and underwent screening. Out of those, 34 (6.64%) were QFT-G positive, whereas 478 (93.36%) were negative. Of the 34 QFT-G-positive HCWs, four had CT findings compatible with active TB and received multidrug treatment; 24 showed no findings of active TB and received isoniazid for six months. All completed their regimens without any adverse effects. The TB screening programme integrating CT and the QFT-G test was safe and feasible. The efficacy of the programme needs to be confirmed by large scale clinical trials.
authors.affiliation: Department of Respiratory Medicine, Saitama Medical University, Saitama, Japan. mycobacteriumtuberculosis@hotmail.com
authors.forename: T
authors.initials: T
authors.lastname: Hirama
authors.forename: K
authors.initials: K
authors.lastname: Hagiwara
authors.forename: M
authors.initials: M
authors.lastname: Kanazawa
mesh_terms: D000328:Adult; D016358:Contact Tracing; D005260:Female; D006282:Health Personnel; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000276:immunology; D016273:Occupational Exposure; D015397:Program Evaluation; D013902:Radiography, Thoracic / Q000379:methods; D011933:Reagent Kits, Diagnostic; D014057:Tomography, X-Ray Computed / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000382:microbiology; D055815:Young Adult
chemical_list: D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma