title: Tuberculosis screening at the Sainte-Anne Hospital in Paris - results of first and second IGRA.
abstract: BACKGROUND
  Healthcare workers (HCWs) are exposed to Mycobacterium tuberculosis (MTB) and therefore are screened for tuberculosis (TB). Results of TB screenings with the Interferon-γ Release Assay (IGRA) in a French psychiatric hospital without a TB ward are described.
  
  
  METHODS
  At the Sainte-Anne Hospital, a referral centre for psychiatric patients throughout the municipal region of Paris, IGRA screening is performed during pre-employment and general health examination or after potential contact to MTB. The QuantiFERON Gold in tube (QFT) is used and data on TB history are assessed in a standardized manner.
  
  
  RESULTS
  Between August 2008 und August 2013 in total 1.192 HCWs were tested and the QFT was positive in 265 (22.2%). Probability of a positive QFT increased with age. A second QFT was performed in 144 HCWs with a positive QFT and 53 (36.8%) HCWs had a reversion. With a positive QFT close to the cut-off (e.g. 0.35-0.7 IU/ml) the odds ratio for a reversion was 4.6 compared to an INF-γ concentration of ≥3.0 IU/ml. Probability of reversion was not influenced by preventive chemotherapy, which was completed by 28 (19.4%) HCWs with a positive QFT. No active TB was detected.
  
  
  CONCLUSIONS
  Prevalence of positive IGRA is high in French HCWs as is the number of reversions in IGRA. Reversion rate is particularly high around the cut-off of the IGRA. A borderline zone will therefore reduce the influence of test variability.
authors.affiliation: Center of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany ; Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany ; Institute for Health Service Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
authors.forename: Albert
authors.initials: A
authors.lastname: Nienhaus
authors.affiliation: Department of Occupational Safety and Health, Sainte-Anne Hospital, Paris, France.
authors.forename: Paul-Kenneth
authors.initials: PK
authors.lastname: Gariepy
authors.affiliation: Department of Occupational Safety and Health, Sainte-Anne Hospital, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Trouve
authors.affiliation: Department of Occupational Safety and Health, Sainte-Anne Hospital, Paris, France.
authors.forename: Christiane
authors.initials: C
authors.lastname: Lhaumet
authors.affiliation: Department of Occupational Safety and Health, Sainte-Anne Hospital, Paris, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Toureau
authors.affiliation: Center of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Peters
keywords: Healthcare workers; Interferon-gamma release assay; Reversion; Tuberculosis