Increased Rate of Tuberculin Skin Test Conversion Among Workers at a University Hospital

1992 ◽  
Vol 13 (10) ◽  
pp. 579-581 ◽  
Author(s):  
Julio A. Ramirez ◽  
Pamela Anderson ◽  
Sharon Herp ◽  
Martin J. Raff
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Tertiary Care ◽  
Community Acquired Pneumonia ◽  
Control Measures ◽  
University Hospital ◽  
Skin Tests ◽  
Tuberculin Skin Test Conversion ◽  
Cdc Guidelines ◽  
Hospital Patients

AbstractObjectives:To summarize the results of an investigation of increased rates of tuberculin skin test conversion in employees at a university hospital.Design:The results of annual tuberculin skin tests performed on all 1,845 hospital employees from 1986 to 1991 were reviewed.Setting:A 450-bed acute tertiary care university hospital.Results:The rate of tuberculin skin test conversion was 0.35% (standard deviation ± 0.15) from 1986 to 1989 and increased to 1.7% during 1991. Investigation revealed deviations from the Centers for Disease Control (CDC) guidelines for tuberculosis control, which included the failure to consider tuberculosis as a probable cause of community-acquired pneumonia and the failure to initiate isolation precautions when tuberculosis was suspected.Conclusions:The epidemic appeared to be secondary to delays in diagnosis and isolation of patients with pulmonary tuberculosis. Future control measures should include isolation of all hospital patients admitted with pneumonia until tuberculosis has been excluded.

Increased Rate of Tuberculin Skin Test Conversion among Workers at a University Hospital

1992 ◽  
Vol 13 (10) ◽  
pp. 579-581 ◽  
Author(s):  
Julio A. Ramirez ◽  
Pamela Anderson ◽  
Sharon Herp ◽  
Martin J. Raff
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
University Hospital ◽  
Tuberculin Skin Test Conversion

scholarly journals Differences in Tuberculin Reactivity as Determined in a Veterans Administration Employee Health Screening Program

2009 ◽  
Vol 16 (4) ◽  
pp. 541-543 ◽  
Author(s):  
Sanjay R. Mehta ◽  
Cathy MacGruder ◽  
David Looney ◽  
Scott Johns ◽  
Davey M. Smith
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Screening Program ◽  
Medical Center ◽  
Skin Testing ◽  
Veterans Administration ◽  
Tuberculin Skin Test Conversion ◽  
Conversion Rates ◽  
Cdc Guidelines ◽  
Health Screening Program

ABSTRACT In response to a difference in pricing, the San Diego Veterans Administration Medical Center changed its tuberculin preparation from Tubersol to Aplisol in the fall of 2006. Following the change, an increased number of employee skin test conversions was noted. Employee tuberculin skin test converters from 2006 were screened with the QuantiFERON Gold (QFT-G) gamma interferon release assay. Those employees who tested negative by QFT-G were asked to repeat their skin test with both Tubersol and Aplisol tuberculin preparations. Of the new purified protein derivative converters, 12 of 14 returned for repeat testing with QFT-G, and the assay was negative for 83% (10/12), positive for 8% (1/12), and indeterminate for 8% (1/12) of the individuals. Nine of the individuals who were QFT-G negative agreed to repeat skin testing with both tuberculin preparations, and 7/8 (87.5%) demonstrated reactivity with the Aplisol preparation, while 0/8 (0%) reacted to the Tubersol preparation. A change from Tubersol to Aplisol resulted in elevated tuberculin skin test conversion rates that may be due to false-positive reactions. The differences in skin test reactivity between preparations support CDC guidelines that recommend that institutions should not change tuberculin preparations, as doing so may falsely increase the number of positive reactions.

scholarly journals Influence of replacing tuberculin skin test with ex vivo interferon γ release assays on decision to administer prophylactic antituberculosis antibiotics before anti-TNF therapy

2012 ◽  
Vol 71 (11) ◽  
pp. 1783-1790 ◽  
Author(s):  
Xavier Mariette ◽  
Gabriel Baron ◽  
Florence Tubach ◽  
Frédéric Lioté ◽  
Bernard Combe ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Ex Vivo ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Interferon Γ ◽  
Specificity And Sensitivity ◽  
Immune Mediated

BackgroundThe recommendations for detecting latent tuberculosis infection (LTBI) before antitumour necrosis factor (anti-TNF) therapy are based on the tuberculin skin test (TST), which lacks both specificity and sensitivity and can lead to unnecessary treatment with antibiotics. A study was undertaken to investigate the effect of replacing TST with interferon γ (IFNγ) release assays (IGRA) in screening for LTBI and deciding to begin prophylactic antituberculosis (TB) antibiotics before anti-TNF therapy in immune-mediated inflammatory diseases.MethodsIn 15 tertiary care hospitals, consecutive patients with rheumatoid arthritis, spondylarthropathies or Crohn's disease were screened for LTBI before anti-TNF therapy with TST, QuantiFERON TB Gold in tube (QTF-Gold IT) and T-SPOT.TB at the same time. The potential diagnosis of LTBI and the effect on the decision to begin antibiotic prophylaxis were assessed.ResultsAmong 429 patients, 392 had results for the three tests. The results for TST, T-SPOT.TB and QTF Gold IT were positive for 35.2%, 15.1% and 9.9% of patients, respectively (p<0.0001). Antibiotics were required for 177 patients (45.2%) if positive TST results were included in the LTBI definition, 107 patients (27.3%) if TST results were replaced with results from one of the IGRA tests and 84 patients (21.4%) if TST results were replaced with QTF-Gold IT results (p<0.0001). The decision on the use of antibiotic prophylaxis was changed for 113 patients (28.8%, 95% CI 24.4% to 33.6%) if TST results were replaced with QTF-Gold IT results.ConclusionsReplacing TST with IGRA for determining LTBI allowed the proportion of patients with immune-mediated inflammatory diseases needing prophylactic anti-TB antibiotics before beginning anti-TNF agents to be reduced by half.TrialRegNo: NCT00811343.

scholarly journals Tuberculin skin test conversion in patients under treatment with anti-tumor necrotizing factor alpha agents

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mohammad-Esmaeil Hejazi ◽  
Atefeh Ahmadzadeh ◽  
Alireza Khabbazi ◽  
Aliasghar Ebrahimi ◽  
Maryam Farmani ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Tuberculin Skin Test Conversion ◽  
Factor Alpha

Epidemiology of Methicillin-ResistantStaphylococcus aureusat a University Hospital in the Canary Islands

2003 ◽  
Vol 24 (9) ◽  
pp. 667-672 ◽  
Author(s):  
Isabel Montesinos ◽  
Eduardo Salido ◽  
Teresa Delgado ◽  
Maria Lecuona ◽  
Antonio Sierra
Keyword(s):  
Canary Islands ◽  
Tertiary Care ◽  
Control Measures ◽  
University Hospital ◽  
Pfge Type ◽  
Staff Members ◽  
Surveillance Cultures ◽  
Underlying Illness ◽  
Hospital Stays ◽  
Prolonged Hospital

AbstractObjectives:To describe the epidemiology of methicillin-resistantStaphylococcus aureus(MRSA) at a university hospital in Tenerife, Canary Islands, during a 40-month period and to evaluate the effectiveness of the application of control measures.Design:Laboratory-based surveillance, medical charts and microbiological records review, and characterization of strains by pulsed-field gel electrophoresis (PFGE) were used to describe the epidemiology. Infection control practices were introduced as an intervention.Setting:A 650-bed, tertiary-care university hospital.Subjects:Patients with clinical and nasal isolates of MRSA and colonized staff members.Results:The rate of nosocomial MRSA infections was 32.5% for 1997, 17.9% for 1998, 14.5% for 1999, and 25.6% during the first 4 months of 2000. The major sites of isolation for nosocomial MRSA infection included surgical wounds (25%) and the lower respiratory tract (24%). Intensive care units and surgical specialties had more frequent MRSA cases. Characteristics associated with nosocomial MRSA isolates included prior use of intensive antibiotic therapy, prolonged hospital stays, major underlying illness, invasive procedures, and older age. PFGE type A (subtype A1) was the strain most frequently found and the only PFGE type involved in clusters.Conclusions:Surveillance cultures and contact droplet precautions were followed by decreased rates for 2 years. Nevertheless, the spread of PFGE subtype Al to many different areas of the hospital and the increase in incidence during the first third of 2000 indicates either that surveillance cultures were not used widely enough or that compliance with isolation measures was suboptimal.

Negative Tuberculin Skin Test and Prediction of Reversion of QuantiFERON Interferon Gamma Release Assay in US Healthcare Workers

2016 ◽  
Vol 37 (4) ◽  
pp. 478-482 ◽  
Author(s):  
Wendy Thanassi ◽  
Art Noda ◽  
Beatriz Hernandez ◽  
Leah Friedman ◽  
Susan Dorman ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Healthcare Workers ◽  
Low Risk ◽  
Infect Control Hosp ◽  
Skin Tests ◽  
Interferon Gamma Release Assay ◽  
Negative Tuberculin Skin Test ◽  
Release Assay

QuantiFERON tuberculosis tests (QFT) reverted in (612) 77% of 1,094 low-risk healthcare workers (HCW) testing less than 1.16 IU/mL. Of HCW testing greater than 1.1 IU/mL, 33 (59%) of 56 with negative tuberculin skin tests (TST) reverted vs 8 (6%) of 125 with positive TSTs. Retesting low-risk QFT-positive and TST-negative HCW is prudent.Infect. Control Hosp. Epidemiol. 2016;37(4):478–482

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