Prevalence of latent tuberculosis infection in healthcare workers at a hospital in Naples, Italy, a low-incidence countr
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RESEARCH
Open Access
Prevalence of latent tuberculosis infection in healthcare workers at a hospital in Naples, Italy, a low-incidence country Monica Lamberti1*, Mariarosaria Muoio1, Antonio Arnese1, Sharon Borrelli1, Teresa Di Lorenzo1, Elpidio Maria Garzillo1, Giuseppe Signoriello2, Stefania De Pascalis2, Nicola Coppola2 and Albert Nienhaus3
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. Keywords: Tuberculosis, Tuberculin skin test, Healthcare workers, Quantiferon test, Health surveillance, Occupational exposure
Background Tuberculosis (TB) is a major health problem worldwide. The World Health Organization estimates that in 2013 there were 9.0 million new cases and 1.5 million TBrelated deaths [1]. Compounding this problem is multidrug-resistant TB, which globally was estimated to affect 3.5% of new TB cases in 2013. Although Italy is considered a low-incidence country for TB-the number of estimated new cases in 2013 was less than 10/100,000 * Correspondence: [email protected] 1 Department of Experimental Medicine, Section of Hygiene, Occupational Medicine and Forensic Medicine, Second University of Naples, Via dei Crecchi 16, 80133 Naples, Italy Full list of author information is available at the end of the article
inhabitants [1] – the disease is still considered a risk owing to abandonment of vaccination campaigns, wide diffusion of primary and secondary immunosuppression, and influx of immigrants [2, 3]. Compared with the general population, health
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