A multicenter evaluation of tuberculin skin test positivity and conversion among health care workers in Brazilian hospitals

• Autor(a) principal: Roth, V. R.
• Data de Publicação: 2005
• Outros Autores: Garrett, D. O., Laserson, K. F., Starling, C. E., Kritski, Afranio Lineu [UNIFESP], Medeiros, Eduardo Alexandrino Servolo de [UNIFESP], Binkin, N., Jarvis, W. R.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/0013000010pv6
• Texto Completo: http://www.ingentaconnect.com/contentone/iuatld/ijtld/2005/00000009/00000012/art00007; http://repositorio.unifesp.br/handle/11600/44120
• topic: tuberculin rest; PPD; tuberculosis; BCG; Brazil

SETTING: Four general Brazilian hospitals.OBJECTIVE: To assess the occupational risk of Mycobacterium tuberculosis (TB) in participating hospitals.DESIGN: In phase one of this longitudinal study, a cross-sectional survey documented baseline tuberculin skin test (TST) positivity rates. In phase two, TST conversion rates were evaluated in participants with an initial negative two-step TST. TST conversion data were analyzed to determine risk factors for TB infection using an increase of >= 10 mm compared to baseline TST.RESULTS: The initial TST positivity rate was 63.1%; the follow-up TST conversion rate was 10.7 per 1000 person-months (p-m). Hospital of employment, recent bacille Calmette-Guerin (BCG) vaccination, nosocomial TB exposure, and employment as a nurse were independent risk factors for TST conversion. Hospitals without TB infection control measures had higher conversion rates than those with control measures (16.0 vs. 7.8/1000 p-m, P < 0.001).CONCLUSIONS: This study indicates an important occupational risk of infection in health care settings with a high TB incidence. Longitudinal TST studies are a valuable tool to assess the occupational risk of TB, even in BCG-vaccinated populations, and should be used to direct limited resources for infection control.