Your browser doesn't support javascript.
loading
Predictors of positive tuberculin skin test in neonates exposed to pulmonary tuberculosis.
Choi, Yun; Kim, In Kyoung; Kim, So Jung; Kim, Hye Sung; Kang, Young Ae; Song, Jin Su.
Afiliação
  • Choi Y; Division of Infectious Disease Response, Capital Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Seoul, Republic of Korea.
  • Kim IK; Division of Infectious Disease Response, Capital Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Seoul, Republic of Korea.
  • Kim SJ; Division of Infectious Disease Response, Capital Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Seoul, Republic of Korea.
  • Kim HS; Division of Infectious Disease Response, Capital Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Seoul, Republic of Korea.
  • Kang YA; Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Song JS; Graduate School of Global Development and Entrepreneurship, Handong Global University, Pohang, Republic of Korea.
PLoS One ; 19(5): e0303050, 2024.
Article em En | MEDLINE | ID: mdl-38722990
ABSTRACT

BACKGROUND:

Neonates are at risk of nosocomial tuberculosis (TB) infection from health care workers (HCWs) in neonatal care facilities, which can progress to severe TB diseases. Tuberculin skin test (TST) is commonly used for TB diagnosis, but its accuracy in neonates is influenced by various factors, including bacilli Calmette-Guérin (BCG) vaccination. This study aimed to identify predictors of positive TSTs in neonates exposed to HCWs with pulmonary TB.

METHODS:

A retrospective observational study was conducted to compare the frequency of predictors between TST-positive and TST-negative neonates. Demographic, epidemiological, and clinical data of neonates exposed to TB, along with that of HCW and household contacts, were collected retrospectively through contact investigations with the Korean National TB Surveillance System (KNTSS) database. TSTs using 2 tuberculin units of purified protein derivative RT23 were performed on exposed neonates at the end of preventive TB treatment. Firth logistic regression was performed to identify predictors of TST positivity.

RESULTS:

Contact investigations revealed that 152 neonates and 54 HCWs were exposed to infectious TB index cases in 3 neonatal care facilities. Of 152 exposed neonates, 8 (5.3%) had positive TST results. Age of 6 days or more at the initial exposure is a statistically significant predictor of positive TST (Firth coefficient 2.1, 95% confidence interval 0.3-3.9, P = 0.024); BCG vaccination showed no statistical significance in both univariable and multivariable analysis. Sex, prematurity, exposure duration, duration from initial exposure to contact investigation, and isoniazid preventive treatment duration were not significant predictors.

CONCLUSION:

Age at the initial exposure is a significant predictor of positive TST in neonates exposed to active pulmonary TB. Given the complexities of TST interpretation, including false positives due to BCG vaccination, careful risk assessment is necessary for appropriate decision-making and resource allocation in the management of neonatal TB exposure.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Limite: Female / Humans / Male / Newborn Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Limite: Female / Humans / Male / Newborn Idioma: En Ano de publicação: 2024 Tipo de documento: Article