ArticlePloS one2014
Occupational screening for tuberculosis and the use of a borderline zone for interpretation of the IGRA in German healthcare workers.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries-A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- Interpretation of serial interferon-gamma test results to measure new tuberculosis infection among household contacts in Zambia and South Africa.BMC infectious diseases · 2020Trial
- Trial
- Effect of Variability on Interferon-Gamma Release Assay Performance: A Quantitative Analysis.Annals of laboratory medicine · 2026Article
- Analysis of Recognized Occupational Infectious Diseases in Germany Between 2018 and 2023.Journal of occupational and environmental medicine · 2025Article
- Characterization of QuantiFERON-TB-Plus Results in Patients with Tuberculosis Infection and Multiple Sclerosis.Neurology international · 2025Article
- Preliminary evaluation of a new prototype interferon-gamma release assay for the detection of Mycobacterium tuberculosis-specific T-cell responses in patients with tuberculosis.Folia microbiologica · 2025Article
- Evaluation of QuantiFERON TB gold plus among TB household contacts in high incidence settings.BMC infectious diseases · 2025Article
- Article
- Intestinal Helminth Infections and Their Association with QuantiFERON-TB Gold Plus Test Performance in an Endemic Setting, Northwest Ethiopia.Infection and drug resistance · 2024Article
- Facilitators and barriers to latent tuberculosis infection treatment among primary healthcare workers in Malaysia: a qualitative study.BMC health services research · 2023Article
- Alternative biomarkers of tuberculosis infection in patients with immune-mediated inflammatory diseases.Frontiers in medicine · 2023Article
- Diagnostic Value of CD25, CD69, and CD134 on Tuberculosis-Specific Antigen-Stimulated CD4+ T Cells for Tuberculous Pleurisy.Journal of immunology research · 2023Article
- Biomarkers to identifyThe European respiratory journal · 2022Article
- The Impact of Borderline Quantiferon-TB Gold Plus Results for Latent Tuberculosis Screening under Routine Conditions in a Low-Endemicity Setting.Journal of clinical microbiology · 2021Article
- Prevalence and risk factors for latent tuberculosis in polish healthcare workers: the comparison of tuberculin skin test and interferon-gamma release assay (IGRA) performance.Journal of occupational medicine and toxicology (London, England) · 2021Article
- Latent Tuberculosis Infection among Health Workers in Germany-A Retrospective Study on Progression Risk and Use of Preventive Therapy.International journal of environmental research and public health · 2021Article
- Cytokine and Chemokine mRNA Expressions afterDiagnostics (Basel, Switzerland) · 2021Article
- Tuberculosis Infection Screening in 5468 Italian Healthcare Students: Investigation of a Borderline Zone Value for the QFT-Test.International journal of environmental research and public health · 2020Article
- Risk Analysis of Latent Tuberculosis Infection among Health Workers Compared to Employees in Other Sectors.International journal of environmental research and public health · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHealthcare workers (HCWs) in low incidence countries with contact to patients with tuberculosis (TB) are considered a high-risk group for latent TB infection (LTBI) and therefore are routinely screened for LTBI. The German Occupational TB Network data is analyzed in order to estimate the prevalence and incidence of LTBI and to evaluate putative risk factors for a positive IGRA and the performance of IGRA in serial testing.
methods3,823 HCWs were screened with the Quantiferon Gold in Tube (QFT) at least once; a second QFT was performed on 817 HCWs either in the course of contact tracing or serial examination. Risk factors for a positive QFT were assessed by a questionnaire.
resultsWe observed a prevalence of LTBI of 8.3%. Putative risk factors for a positive QFT result were age >55 years (OR 6.89), foreign country of birth(OR 2.39), personal history of TB (OR 6.25) and workplace, e.g. infection ward (OR 1.76) or geriatric care (OR 1.99). Of those repeatedly tested, 88.2% (721/817) tested consistently QFT negative and 47 were consistently QFT-positive (5.8%). A conversion was observed in 2.8%(n = 21 of 742 with a negative first QFT) and a reversion occurred in 37.3% (n = 28 of 75 with a positive first QFT). Defining a conversion as an increase of the specific interferon concentration from <0.2 to >0.7 IU/ml, the conversion rate decreased to 1.2% (n = 8). Analogous to this, the reversion rate decreased to 18.8% (n = 9) [corrected]. DISCUSSION: In countries with a low incidence of TB and high hygiene standards, the LTBI infection risk for HCWs seems low. Introducing a borderline zone from 0.2 to ≤ 0.7 IU/ml may help to avoid unnecessary X-rays and preventive chemotherapy. No case of active TB was detected. Therefore, it might be reasonable to further restrict TB screening to HCWs who had unprotected contact with infectious patients or materials.
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