TB testing for hospital employees: new recommendations

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Occupational Health

Background:

• Tuberculin skin testing (TST) is widely used for tuberculosis screening in healthcare settings.
• The booster phenomenon, where prior TST can stimulate a positive reaction in individuals not newly infected, complicates interpretation.
• Increased frequency of TST in employee programs highlights the need to address the booster effect.

Purpose of the Study:

• To investigate the booster phenomenon in the context of routine hospital employee tuberculosis screening.
• To develop and recommend a revised TST procedure to mitigate the impact of the booster effect.
• To enhance the reliability of TST in detecting true new tuberculosis infections.

Main Methods:

• The study was conducted by the Tuberculosis Control Division of the Center for Disease Control.
• A specific methodology was employed to assess the booster phenomenon during TST administration.
• Data analysis focused on differentiating between boosted reactions and true infections.

Main Results:

• The study identified factors contributing to the booster phenomenon in serial TST.
• The recommended new testing procedure was shown to effectively minimize the booster effect.
• A significant reduction in false-positive conversions due to boosting was observed.

Conclusions:

• The revised TST protocol offers greater certainty in identifying new tuberculosis infections.
• Implementing the new procedure can improve the accuracy of tuberculosis surveillance programs for healthcare workers.
• Minimizing the booster phenomenon is crucial for effective tuberculosis control in occupational health settings.