論文ID: JJID.2017.274
Tuberculosis (TB) among healthcare workers (HCWs) highly impacts morbidity and TB transmission in hospital. A retrospective cohort study of TB among HCWs (HCW-TB) was conducted using a registered database from 2003 to 2016 at Chiang Mai University Hospital to determine clinical and microbiological characteristics and treatment outcomes of HCW-TB. Seventy-six cases of HCWs, 54 nurses (71.1%), 12 physicians (15.8%) and 10 paramedics (13.2%), were diagnosed with TB disease. Female to male ratio of 51:25, mean age of 37.0±11.6 years and median work duration of 12.0 years (5-20) and BMI of 19.4±2.5 kg/m2. Categorized TB cases by working place, were 28 (36.8%) in the Medical Department, 12 (15.8%) in the Outpatient Department/Emergency Room, 9 (11.8%) in the Surgical Department. Pulmonary TB (PTB) is the most common (92.1%) manifestation of HCW-TB. The sputum acid-fast stains were positive among 28 (40.0%) HCWs with PTB. Cultures were positive M. tuberculosis in 26 (34.2%) cases. Drug susceptibility testing showed sensitivity to all first-line drug with 75.0%, resistance to any one first line drug of 20.8%, and multidrug-resistant TB (MDR-TB) of 4.2%. The success rate at end of treatment was 100%. Therefore, TB control guidelines should be strictly implemented to prevent TB transmission in healthcare settings.
