In a Hospital Setting, is There any Benefit in Prioritizing Risk following Exposure to Tuberculosis? - A Preliminary Report
Panthong J, MD1, Chaiear N, MD, MMedSc, PhD1, Jongkumchok W, MD1, Janpho P, BNS2
Affiliation : 1 Division of Occupational Medicine, Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Occupational Health and Safety Office, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Objective : To study a program of post-exposure management for pulmonary tuberculosis (TB) in the hospital setting.
Materials and Methods : A study was conducted among hospital personnel (HP) from March 2016 to June 2017. A program of post-
exposure management for pulmonary TB in the hospital setting was instituted which followed the “Guidelines for the Investigation
of Contacts of Persons with Infectious Tuberculosis: Recommendations from the National Tuberculosis Controllers Association
and CDC” using the QuantiFERON®-TB Gold In-Tube assay (QFT-GIT), an Interferon-Gamma Release Assay (IGRA), as a screening
test.
Results : Three hundreds and twelve HP were classified as the contact persons and 15 TB patients were confirmed as the index cases.
Among 312 HP, 134 (42.9%) was classified as high or medium priority contacts, and 30 of them (22.4%) were investigated by QFT-
GIT after being exposed. Two HP (6.7%) revealed positive result and were confirmed as having latent tuberculosis infection, but
only one HP accepted INH preventive treatment. Twenty six (8.3%) HP could not be prioritized due to their incomplete information.
Conclusion : This program was unable to statistically identify the post-exposed HP with infectious tuberculosis due to limited
numbers. The appropriate guidelines need to be developed more clearly with definition of a ‘close contact’. This will be more useful
for Thailand hospital settings.
Keywords : Latent tuberculosis infection, Hospital personnel, Post-exposure, Interferon-Gamma Release Assay
