title: Prevalence of latent tuberculosis infection in healthcare workers at a hospital in Naples, Italy, a low-incidence country.
abstract: BACKGROUND
  Healthcare workers (HCWs) are at higher risk than the general population of contracting tuberculosis (TB). Moreover, although subjects with latent TB infection (LTBI) are asymptomatic and are not infectious, they may eventually develop active disease. Thus, a fundamental tool of TB control programs for HCWs is the screening and treatment of LTBI.
  
  
  METHODS
  From January 2014 to January 2015, hospital personnel at Azienda Ospedaliera Universitaria, Naples, Italy, were screened for TB. To this end, a tuberculin skin test (TST) was administered as an initial examination, unless when contraindicated, in which case the QuantiFERON® TB-Gold (QFT) assay was performed. Moreover, QFT was carried out on all TST-positive cases to confirm the initial result.
  
  
  RESULTS
  Of 628 personnel asked to participate, 28 (4.5%) denied consent, 533 were administered TST as the baseline examination, and 67 were tested only with QFT. In the TST group, 73 (13.2%) individuals were found positive, 418 (78.4%) were negative, and 42 (7.9%) were absent for the reading window; QFT confirmed the result in 39 (53.4%) TST-positive individuals. In the QFT-only group, 44 (65.7%) individuals were found positive. All TST- and/or QFT-positive subjects were referred for chest X-ray and examination by an infectious diseases specialist. None were found to have active TB, and were thus diagnosed with LTBI.
  
  
  CONCLUSIONS
  Although Italy is a low-incidence country regarding TB, our findings suggest that the prevalence of LTBI in HCWs may be relatively high. As a result, active screening for TB and LTBI is needed for these workers.
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, 80133 Naples, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Lamberti
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, 80133 Naples, Italy.
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Muoio
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, 80133 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Arnese
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, 80133 Naples, Italy.
authors.forename: Sharon
authors.initials: S
authors.lastname: Borrelli
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, 80133 Naples, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Di Lorenzo
authors.affiliation: Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, 80133 Naples, Italy.
authors.forename: Elpidio Maria
authors.initials: EM
authors.lastname: Garzillo
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Signoriello
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: De Pascalis
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Coppola
authors.affiliation: Institute for Health Services, Research in Dermatology and Nursing, Germany, Institution for Statutory Accident Insurance and Prevention in Healthcare and Welfare Services, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Albert
authors.initials: A
authors.lastname: Nienhaus
keywords: Health surveillance; Healthcare workers; Occupational exposure; Quantiferon test; Tuberculin skin test; Tuberculosis