Recs Updated for TB Screening, Treatment in Health Care Workers

Guidelines have been updated for screening and treatment for tuberculosis (TB) infection among health care personnel, according to research published in the May 17 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Lynn E. Sosa, M.D., from the National Tuberculosis Controllers Association in Smyrna, Georgia, and colleagues conducted a systematic review to examine the proportion of health care personnel with TB and developed updated recommendations for screening, testing, and treatment.

The researchers note that based on meta-analyses, 5 and 3 percent of U.S. health care personnel tested positive at baseline by interferon-gamma release assay and tuberculin skin test, respectively; during serial testing, 4 and 0.7 percent, respectively, converted from a negative to a positive. Updated recommendations for TB screening include preplacement TB risk assessment and symptom evaluation. Postexposure symptom evaluation and TB testing are recommended among those without prior TB or latent TB infection (LTBI). Serial screening or testing is not recommended for those without LTBI. Additional workup is recommended for those with positive test results or symptoms compatible with TB. Those diagnosed with LTBI should be treated, and annual symptom screening should be conducted for persons with untreated LTBI. TB education is recommended for all health care professionals.

"Health care facilities should aim to identify LTBI among health care personnel and encourage LTBI treatment," the authors write. "Health care facilities are urged to collaborate with public health agencies to assist in achieving this goal."

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