Tuberculosis Screening Using a T-Cell Interferon-γ Release Assay in Japanese Medical Students and Non-Japanese International Students
Tuberculosis Screening Using a T-Cell Interferon-γ Release Assay in Japanese Medical Students and Non-Japanese International Students
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DOI：
10.1620/tjem.230.87
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发表时间：
2013-06-01
影响因子：
2.2
通讯作者：
Murakami, Masami
中科院分区：
文献类型：
--
作者：
Ogiwara, Takayuki;Kimura, Takao;Murakami, Masami
由于接触结核病患者的风险很高，在入院时对医学生和国际学生进行结核病筛查是控制和预防大学校园和教学医院感染传播的一项关键策略。结核分枝杆菌抗原特异性 T 细胞干扰素-γ 释放测定 (IGRA) 是此类群体中使用的特异性潜伏性结核病检测方法。目前，在日本，没有关于 IGRA 的指南和基线数据来评估这些高危人群的结核病风险。为了评估日本大学校园和医学院入学时的结核病风险，进行了一项回顾性研究。共有 969 名学生（585 名日本学生和 384 名国际学生）在入学时使用 IGRA 进行了结核病筛查。八名日本学生（0.9%）的 IGRA 呈阳性，但在随访中没有人被诊断出患有活动性结核病。相比之下，30 名国际学生 (7.8%) 的 IGRA 呈阳性，其中包括两名在随访过程中被诊断出患有活动性结核病的学生。入学时国际学生IGRA阳性率明显高于医学生。在此，我们提出了一种在日本医学生和国际学生入学时使用 IGRA 进行结核病筛查的标准方法。
Screening of medical students and international students for tuberculosis (TB) at the time of admission is a key strategy to control and prevent the spread of infection on university campus and teaching hospitals because of the high risk of exposure to TB patients. The Mycobacterium tuberculosis antigen-specific T-cell interferon-gamma release assays (IGRAs) are specific latent tuberculosis detection methods used in such groups. Currently, in Japan, there are no guidelines and no baseline data on IGRAs to evaluate the risk of TB in these high-risk groups. In order to evaluate TB risk at the time of admission in university campus and medical schools in Japan, a retrospective study was conducted. A total of 969 students (585 Japanese students and 384 international students) were screened for TB using the IGRAs at the time of admission. Eight Japanese students (0.9%) were positive for IGRAs, but none were diagnosed with active TB at the follow-up. In contrast, 30 international students (7.8%) were positive for IGRAs, including two students diagnosed with active TB during follow up. Positive ratio of IGRAs in international students was significantly higher than that of medical students at the time of admission. Here we propose a standard approach for TB screening with IGRAs at the time of admission for medical students and international students in Japan.