醫療人員結核菌素測驗陽性之意義

Tuberculin Skin Tests for Health Care Workers in a Local Hospital in Northern Taiwan

10.6526/ICJ.200406_14(3).0002

鄭舒倖(Shu-Hsing Cheng)；黃婉瑩(Wan-Ying Haung)；莊意芬(Yih-Fen Chuang)；劉勝芬(Shen-Feng Liu)；索任；陳重達(Jung-Dar Chen)

結核病 ； 結核菌素測驗 ； tuberculosis ； tuberculin skin test

感染控制雜誌

14卷3期（2004 / 06 / 01）

140 - 149

繁體中文

Since 1985, there has been a increase in the new patients with tuberculous infections worldwide. There are 14,000 cases of newly diagnosed tuberculosis (TB) in Taiwan annually. More than 70% of these were diagnosed in the hospital. The risk of exposure of the hospital personnel can not be neglected. We applied tuberculin skin test (TST) with 1 tuberculin unit of Purified Protein Derivatives to our hospital staff during one month period in 2001. They were followed up for the next 12 months. A total of 380 persons were enrolled in the study. 32.4%, or 99 persons, had TST results showing the induration of 10mm or larger diameter. 18.4%, or 56, had the induration of 15mm or larger. The infection rate is significantly higher than that of the general population (12.9% for people of 30 years old. relative risk=1.90, p＜0.001). Nurses, housekeepers, secretaries had similar positive TST rates: 29.4-32.4% had TST result of 10mm or larger; 15.8-18.4% had 15mm or larger. The staffs working in the pediatric ward and pediatric/neonatal intensive care units have significantly higher positive TST rates (p＜0.5). At the end of one-year follow-up period, no one developed active tuberculosis. TST is not boosted by previous vaccination which most people had completed before 12 years of age in Taiwan. We suggest that all health care workers to receive TST regularly. Prophylactic medications should be considered for those who have positive TST conversion.

Since 1985, there has been a increase in the new patients with tuberculous infections worldwide. There are 14,000 cases of newly diagnosed tuberculosis (TB) in Taiwan annually. More than 70% of these were diagnosed in the hospital. The risk of exposure of the hospital personnel can not be neglected. We applied tuberculin skin test (TST) with 1 tuberculin unit of Purified Protein Derivatives to our hospital staff during one month period in 2001. They were followed up for the next 12 months. A total of 380 persons were enrolled in the study. 32.4%, or 99 persons, had TST results showing the induration of 10mm or larger diameter. 18.4%, or 56, had the induration of 15mm or larger. The infection rate is significantly higher than that of the general population (12.9% for people of 30 years old. relative risk=1.90, p＜0.001). Nurses, housekeepers, secretaries had similar positive TST rates: 29.4-32.4% had TST result of 10mm or larger; 15.8-18.4% had 15mm or larger. The staffs working in the pediatric ward and pediatric/neonatal intensive care units have significantly higher positive TST rates (p＜0.5). At the end of one-year follow-up period, no one developed active tuberculosis. TST is not boosted by previous vaccination which most people had completed before 12 years of age in Taiwan. We suggest that all health care workers to receive TST regularly. Prophylactic medications should be considered for those who have positive TST conversion.