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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제51권 제4호
발행연도
2019.1
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355 - 364 (10page)

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Background: Healthcare workers (HCWs) have a high risk of tuberculosis (TB) infection. Since August 2017, Korea has mandated the testing of latent TB infection (LTBI) and recommended treatment from HCWs at medical institutions. However, the acceptance/completion rate and adverse events of LTBI treatment have not been analyzed. Materials and Methods: From February to August 2017, we conducted a retrospective study at a referral university hospital in Korea, to screen the interferon-gamma release assay (IGRA) tests conducted for all HCWs for detecting and treating LTBI. HCWs diagnosed with LTBI were offered a 9-month isoniazid (9H), 3-month isoniazid/rifampin (3HR), or 4-month rifampin regimen. We investigated the acceptance/completion rate, adverse events, and causes of discontinuation or change in LTBI medication. A major adverse event was one wherein a patient had any adverse event ≥grade 3 causing LTBI treatment interruption. Results: Of the 1,538 HCWs, 1,379 underwent IGRA testing for LTBI. Among them, 13.6% (187/1,379) tested positive and 73.3% (137/187) received treatment. The overall completion rate was 97.8% (134/137). HCWs were significantly more likely to complete first-line therapy with 3HR than with 9H (91.4% vs. 76.7%, P = 0.02). The most common major adverse event was hepatotoxicity (n = 7), followed by thrombocytopenia (n = 1) and anaphylactic shock (n = 1). Hepatotoxicity and hepatotoxicity (≥ grade 2) were more frequent in 9H than in 3HR (39.5% vs. 17.2%, P = 0.006 and 18.6% vs. 3.7%, P = 0.005, respectively). The median time to hepatotoxicity was 96 days (interquartile range, 20 – 103 days). Conclusion: Completion of first-line therapy for LTBI is more likely with 3HR than with 9H. This might be related to the development of hepatotoxicity after around 3 months of treatment. Anaphylactic shock and platelet count should be carefully monitored in those receiving rifampin-containing regimens.

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참고문헌 (23)

참고문헌 신청
이지은 / 2011 / What Strategy Can be Applied to the Patients with Culture Positive Tuberculosis to Reduce Treatment Delay in a Private Tertiary Healthcare Center? / Infection and Chemotherapy 43(1):42~47 dbpia Park HY / 2010 / Interferon-γ release assay for tuberculosis screening of healthcare workers at a Korean tertiary hospital / Scand J Infect Dis 42:943~945 google schola Lee K / 2009 / Annual incidence of latent tuberculosis infection among newly employed nurses at a tertiary care university hospital / Infect Control Hosp Epidemiol 30:1218~1222 google schola 박세윤 / 2019 / Aggressive Contact Investigation of In-Hospital Exposure to Active Pulmonary Tuberculosis / Journal of Korean Medical Science 34(7):1~8 dbpia Jensen PA / 2005 / Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005 / MMWR Recomm Rep 54:1~141 google schola

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