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Room size is the major determinant for tuberculin conversion in health care workers exposed to a multidrug-resistant tuberculosis patient

Room size is the major determinant for tuberculin conversion in health care workers exposed to a multidrug-resistant tuberculosis patient
Room size is the major determinant for tuberculin conversion in health care workers exposed to a multidrug-resistant tuberculosis patient
Objective: transmission of Mycobacterium tuberculosis (MTB) to health care workers (HCWs) still represents a public health concern. A total of 71 obstetric workers underwent contact tracing after recent workplace exposure to a highly infectious multidrug-resistant tuberculosis patient [i.e., index case (IC)]. Aim of the study was to identify the main exposure predictors for the risk of conversion through evaluation of tuberculin screening results.

Methods: HCWs were investigated by a questionnaire (community, occupational, IC exposure risk factors) and tuberculin skin test screening.

Results: conversion was detected in 5 (8%) of the 63 exposed workers and was not associated with either community or previous work-related risk factors. According to risk assessment, tuberculin conversion was related to neither amount time of exposure, workshifts, nor number of contacts. Conversely, an exposure to the IC in different hospital rooms was found significantly different among converters compared to non-converters (? 2, P = 0.004). In particular, conversion was associated with exposure in two (obstetric emergency room, ambulatory discharge) out of the nine contact environments. Tuberculin conversion rates were associated with the room cubations of the exposure environments (? 2 for trend, P < 0.01) and with worker age. In a logistic regression model adjusted for age, the lower room cubation was found the strongest predictor for tuberculin conversion (OR = 2.46, P = 0.02).

Conclusion: the study shows that the factors affecting airborne mycobacterial dose (patient infectiousness, low sized confined rooms) were the major determinants for MTB transmission after a brief exposure to a highly infectious TB case
0340-0131
533-538
Franchi, Alberto
a3c399dd-995f-4985-b3b2-02d086fc34ca
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Parrinello, Giovanni
a667de1a-5b84-4455-81ff-1dea46a342a1
Franco, Giuliano
cd43c69d-03ba-40e5-a9ac-3291d0d95457
Franchi, Alberto
a3c399dd-995f-4985-b3b2-02d086fc34ca
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Parrinello, Giovanni
a667de1a-5b84-4455-81ff-1dea46a342a1
Franco, Giuliano
cd43c69d-03ba-40e5-a9ac-3291d0d95457

Franchi, Alberto, Richeldi, Luca, Parrinello, Giovanni and Franco, Giuliano (2007) Room size is the major determinant for tuberculin conversion in health care workers exposed to a multidrug-resistant tuberculosis patient. International Archives of Occupational and Environmental Health, 80 (6), 533-538. (doi:10.1007/s00420-006-0160-1). (PMID:17165066)

Record type: Article

Abstract

Objective: transmission of Mycobacterium tuberculosis (MTB) to health care workers (HCWs) still represents a public health concern. A total of 71 obstetric workers underwent contact tracing after recent workplace exposure to a highly infectious multidrug-resistant tuberculosis patient [i.e., index case (IC)]. Aim of the study was to identify the main exposure predictors for the risk of conversion through evaluation of tuberculin screening results.

Methods: HCWs were investigated by a questionnaire (community, occupational, IC exposure risk factors) and tuberculin skin test screening.

Results: conversion was detected in 5 (8%) of the 63 exposed workers and was not associated with either community or previous work-related risk factors. According to risk assessment, tuberculin conversion was related to neither amount time of exposure, workshifts, nor number of contacts. Conversely, an exposure to the IC in different hospital rooms was found significantly different among converters compared to non-converters (? 2, P = 0.004). In particular, conversion was associated with exposure in two (obstetric emergency room, ambulatory discharge) out of the nine contact environments. Tuberculin conversion rates were associated with the room cubations of the exposure environments (? 2 for trend, P < 0.01) and with worker age. In a logistic regression model adjusted for age, the lower room cubation was found the strongest predictor for tuberculin conversion (OR = 2.46, P = 0.02).

Conclusion: the study shows that the factors affecting airborne mycobacterial dose (patient infectiousness, low sized confined rooms) were the major determinants for MTB transmission after a brief exposure to a highly infectious TB case

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Published date: May 2007
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 368969
URI: https://eprints.soton.ac.uk/id/eprint/368969
ISSN: 0340-0131
PURE UUID: 8a186bf6-3a25-48a6-a127-802e3c85bf92

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Date deposited: 09 Oct 2014 13:10
Last modified: 18 Jul 2017 01:41

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