Screening for Tuberculosis in Health Care Workers: Experience in an Italian Teaching Hospital.
Health care workers (HCW) are particularly at risk of acquiring tuberculosis (TB), even in countries with low TB incidence. Therefore, TB screening in HCW is a useful prevention strategy in countries with both low and high TB incidence. Tuberculin skin test (TST) is widely used although it suffers of low specificity; on the contrary, the in vitro enzyme immunoassay tests (IGRA) show superior specificity and sensitivity but are more expensive. The present study reports the results of a three-year TB surveillance among HCW in a large teaching hospital in Rome, using TST (by standard Mantoux technique) and IGRA (by QuantiFERON-TB) as first- and second-level screening tests, respectively. Out of 2290 HCW enrolled, 141 (6.1%) had a positive TST; among them, 99 (70.2%) underwent the IGRA and 16 tested positive (16.1%). The frequency of HCW tested positive for TB seems not far from other experiences in low incidence countries. Our results confirm the higher specificity of IGRA, but, due to its higher cost, TST can be considered a good first level screening test, whose positive results should be further confirmed by IGRA before the patients undergo X-ray diagnosis and/or chemotherapy.
Department of Medical Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy; Health Direction, University Hospital Sant'Andrea, Via di Grottarossa 1035/1039, 00189 Rome, Italy.
Christian
0000-0002-5775-2276
C
Napoli
Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
Filippo
0000-0002-0870-2344
F
Ferretti
Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
Filippo
0000-0002-4144-3292
F
Di Ninno
Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
Riccardo
R
Orioli
Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
Alessandra
A
Marani
Department of Medical Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy.
Maria Giuditta
MG
Sarlo
Department of Medical Surgical Sciences and Translational Medicine, "Sapienza" University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy.
Claudio
C
Prestigiacomo
Health Direction, University Hospital Sant'Andrea, Via di Grottarossa 1035/1039, 00189 Rome, Italy.
Assunta
A
De Luca
Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy.
Giovanni Battista
GB
Orsi
D000328:Adult; D005260:Female; D006282:Health Personnel; D006784:Hospitals, Teaching; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods*; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control; D059425:Interferon-gamma Release Tests / Q000379:methods*; D007558:Italy; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D014374:Tuberculin Test / Q000379:methods*; D014376:Tuberculosis / Q000175:diagnosis* / Q000473:pathology