Latent tuberculosis infection among a large cohort of medical students at a teaching hospital in Italy.

Paolo Durando,Guglielmo Dini,Valerio Del Bono,Giancarlo Icardi,Laura Sticchi,Dimitri Sossai,Claudio Viscoli,Cristiano Alicino,Giovanni Orengo,Filippo Ansaldi,Ilaria Barberis,Francesco Copello,Andrea Orsi,Chiara Paganino,Giovanni Mazzarello

doi:10.1155/2015/746895

Paolo Durando, Guglielmo Dini + Show 13 more

Open Access

https://doi.org/10.1155/2015/746895

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Abstract

The surveillance of latent tuberculosis infection (LTBI) in both healthcare workers and healthcare students is considered fundamental for tuberculosis (TB) prevention. The aim of the present study was to estimate LTBI prevalence and evaluate potential risk-factors associated with this condition in a large cohort of medical students in Italy. In a cross-sectional study, performed between March and December 2012, 1511 eligible subjects attending the Medical School of the University of Genoa, trained at the IRCCS San Martino-IST Teaching Hospital of Genoa, were actively called to undergo the tuberculin skin test (TST). All the TST positive cases were confirmed with an interferon-gamma release assay (IGRA). A standardized questionnaire was collected for multivariate risk analysis. A total of 1302 (86.2%) students underwent TST testing and completed the questionnaire. Eleven subjects (0.8%) resulted TST positive and LTBI diagnosis was confirmed in 2 (0.1%) cases. Professional exposure to active TB patients (OR 21.7, 95% CI 2.9–160.2; P value 0.003) and previous BCG immunization (OR 28.3, 95% CI 3.0–265.1; P value 0.003) are independently associated with TST positivity. Despite the low prevalence of LTBI among Italian medical students, an occupational risk of TB infection still exists in countries with low circulation of Mycobacterium tuberculosis.

Highlights

A work-related risk of latent tuberculosis infection (LTBI) and active tuberculosis (TB) among healthcare workers (HCWs) exists even in areas with low incidence of TB among the general population, such as Europe [1,2,3]
The surveillance of latent tuberculosis infection (LTBI) in both healthcare workers and healthcare students is considered fundamental for tuberculosis (TB) prevention
Despite the low prevalence of LTBI among Italian medical students, an occupational risk of TB infection still exists in countries with low circulation of Mycobacterium tuberculosis

Summary

Introduction

A work-related risk of latent tuberculosis infection (LTBI) and active tuberculosis (TB) among healthcare workers (HCWs) exists even in areas with low incidence of TB among the general population, such as Europe [1,2,3]. The majority of occupational active cases in the healthcare sector occur when the TB infection risk is underestimated and control programs are lacking [4, 5]. Medical students attending teaching hospitals could be exposed to similar occupational risks as HCWs. screening for LTBI of these categories, for an early diagnosis of cases and preventing progression to active disease, represents a fundamental aspect of hospital infection control programs and is recommended in low-incidence TB countries, including Italy [9,10,11] Screening for LTBI of these categories, for an early diagnosis of cases and preventing progression to active disease, represents a fundamental aspect of hospital infection control programs and is recommended in low-incidence TB countries, including Italy [9,10,11].

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