TUBERCULIN SKIN-TEST CONVERSION IN-HOSPITAL EMPLOYEES VACCINATED WITH BACILLE CALMETTE-GUERAN - RECENT MYCOBACTERIUM-TUBERCULOSIS INFECTION OR BOOSTER EFFECT
TUBERCULIN SKIN-TEST CONVERSION IN-HOSPITAL EMPLOYEES VACCINATED WITH BACILLE CALMETTE-GUERAN - RECENT MYCOBACTERIUM-TUBERCULOSIS INFECTION OR BOOSTER EFFECT
复制标题
DOI：
10.1016/0196-6553(95)90039-x
复制
发表时间：
1995-06-01
影响因子：
4.9
通讯作者：
WORMSER, GP
中科院分区：
文献类型：
--
作者：
HOROWITZ, HW;LUCIANO, BB;WORMSER, GP
目的：1991年至1993年期间，我们医疗中心的员工中纯化蛋白衍生物（PPD）皮试转换的发生率上升，这促使我们检查与PPD皮试转换相关的因素。我们专注于卡介苗（BCG）接种对PPD皮试转换的影响，因为在1990年的员工健康服务政策的变化，休息的人谁收到了BCG vaccination.Methods：这项研究发生在一所大学教学医院员工健康服务。PPD皮试转换员工图表（如果年龄小于35岁，2年内PPD反应的硬结增加> 10 mm，如果年龄大于35岁，硬结增加> 15 mm）对1988年至1993年间可能影响PPD皮试转换的因素进行了回顾，并与271名随机选择的接受PPD皮试的员工的数据进行了比较。结果：PPD皮试转换率从0.06%（1/1604）上升到1.3%（22/1760; p = 0.000001），在1988年和1993年之间测试的雇员。在1991年至1993年期间，41名PPD皮试转换者中，29人（71%）接受了卡介苗接种。只有21%的对照受试者（56/271）接受了BCG疫苗接种（PPD皮试转换者与对照受试者之间BCG疫苗接种的比较p < 0.000001）。当卡介苗接种者未被纳入PPD皮试转化时，PPD皮试转化率没有显著增加。23 BCG收件人PPD皮肤试验转换对他们的第二PPD skin tests.Conclusion：PPD皮肤试验转换在医院，雇用大量的卫生保健工作者谁接受了BCG疫苗接种的比例很大可能不代表最近获得的结核病。相反，这些转换可能是以前接种卡介苗的影响，两步初始PPD皮肤测试可能有助于消除近80%的假阳性转换。
Objective: A rise in the incidence of purified protein derivative (PPD) skin test conversions among employees at our medical center between 1991 and 1993 prompted an examination of factors associated with PPD skin test conversion. We focused on the effect of bacille Calmette-Guerin (BCG) vaccination on PPD skin test conversion because of changes in employee health service policies in 1990 regarding resting of persons who had received BCG vaccination.Methods: The study took place in a university teaching hospital employee health service. Charts of employees who had PPD skin test conversion (> 10 mm increase in induration of the PPD response within 2 years if younger than 35 years of age or > 15 mm if older than 35 years of age) between 1988 and 1993 were reviewed for factors that could have influenced PPD skin test conversion and compared with data from 271 randomly selected charts of employees who underwent annual employee assessments in 1993 but did not have PPD skin test conversion.Results: PPD skin test conversions rose from 0.06% (1/1604) to 1.3% (22/1760; p = 0.000001) in employees tested between 1988 and 1993. Of 41 persons with PPD skin test conversion between 1991 and 1993, 29 (71%) had received BCG vaccination. Only 21% of control subjects (56/271) had received BCG vaccination(p < 0.000001 for comparison of BCG vaccination among those with PPD skin test conversion with that among control subjects). When BCG recipients were not included as having PPD skin test conversion, there was no significant increase in PPD skin test conversions. Twenty-three BCG recipients had PPD skin test conversion on their second PPD skin tests.Conclusion: A large proportion of PPD skin test conversions at hospitals that employ large numbers of health care workers who have received BCG vaccination may not represent recently acquired tuberculosis. Rather, these conversions may be effects of previous BCG vaccination, Two-step initial PPD skin testing may help to eliminate nearly 80% of such false-positive conversions.