Protect healthcare personnel with accurate testing and targeted treatment

Healthcare personnel are at increased risk of tuberculosis (TB) infection (1). During the COVID-19 crisis, the CDC has called on healthcare institutions to maintain TB testing and treatment services – while also minimizing patient and provider exposure to SARS-CoV-2 (2). The highly transmissible nature of SARS-CoV-2 demands a systematic push towards remote care and minimization of patient-provider contact.

Streamline onboarding with QuantiFERON-TB Gold Plus

Accurate diagnostic testing is critical to protect those at risk for TB – and to protect the healthcare providers who care for them. QuantiFERON-TB Gold plus provides highly accurate, single visit TB testing:

  • Limit patient and staff testing visits
  • Avoid potential repeated exposure to SARS-CoV-2
  • Reduce unnecessary treatment and chest x-rays

On-demand webinar: Healthcare provider testing with Dr. Kawamura

Join Dr. Masae Kawamura as she introduces the CDC’s latest national testing guidelines, their scientific rationale, and their implications for healthcare facilities and occupational health programs. Dr. Kawamura will also share the new evidence and advantages of QuantiFERON-TB Gold Plus for healthcare provider testing in the context of the new guidelines.

QFT-Plus ensures rapid and reliable onboarding of healthcare workers

To protect providers from TB, the CDC now recommends baseline TB screening and risk-based testing following potential TB exposure (3). QFT-Plus ensures rapid and reliable onboarding, while also serving a critical role in risk-based TB testing and active TB contact investigations – the backbone of the US TB prevention policies.

QFT-Plus advantages compared to the tuberculin skin test for healthcare worker testing

CharacteristicsQFT-PlusTST/PPD
Single visitYesNo
Results in 24–48 hoursYesNo
Unaffected by BCG vaccineYesNo
Objective resultsYesNo
Available automation using the LIAISON QuantiFERON-TB Gold Plus test*YesNo

Unlike the tuberculin skin test, two-step testing is not required for QFT-Plus because IGRA testing does not boost subsequent test results (4).



Learn about the CDC’s latest TB testing guidelines

To protect healthcare personnel, in 2019 the CDC updated its tuberculosis testing guidelines and changed the way hospitals screen their patients and employees for TB. The new recommendations eliminate annual TB screening, but recommend baseline risk assessment and screening during healthcare personnel (HCP) onboarding as well as risk-based testing following TB exposure or changes in risk profile (3).

Where can I find the latest CDC guidelines on healthcare personnel testing?

The US CDC released updated recommendations on healthcare personnel TB testing in May 2019 (1). These recommendations can be found at https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a3.htm

Why should I test healthcare personnel for TB?

Testing healthcare personnel has been one of the commonly held dogmas in TB testing. Healthcare providers are at increased risk of TB infection, though the risk of infection and progression can be highly variable depending on the local prevalence of TB. The risk for TB is impacted by the provider's origins, prior exposures to TB, age and time spent working in healthcare. The risk may be similar to the local population in low-incidence settings or much higher in high-incidence countries (1).

How often should providers be screened for TB infection?

Most recommendations in low-prevalence countries, including those of the CDC, now consider that healthcare personnel should be screened once at hiring or at the beginning of their occupation (3). After that, personnel should not be screened unless there is a documented exposure and the person was negative at hiring.

How do we test nursing students or providers working in TB clinics or correctional facilities?

Nursing students and healthcare providers working in correctional facilities or TB clinics are all covered by the 2019 CDC guidelines and annual testing is not required unless the epidemiology supports it. The CDC's 2005 TB infection control guidelines clearly define the many categories of workers and personnel (5).

Should an asymptomatic TB-positive healthcare provider be allowed to start working?

Latent TB infection (LTBI) is not a reason to exclude a healthcare provider from the workplace. However, if they have a positive test and have not been evaluated with a chest X-ray to rule out active TB, they should not work until a repeat test determines they are negative (if they are at low risk) or they are cleared with a chest X-ray. The TST or IGRA TB test is one for TB immunity. A positive test therefore requires evaluation and a chest X-ray to differentiate LTBI or active TB.

View additional resources on QFT-Plus healthcare worker testing.

*QuantiFERON blood collection tubes by QIAGEN, LIAISON Analyzer by DiaSorin

References

1. Uden et al. (2017) Risk of Tuberculosis Infection and Disease for Health Care Workers: An Updated Meta-Analysis. Open Forum Infect. Dis. 2017 Summer; 4(3): ofx137.
2. CDC. Interim CDC Guidance on Handling Non-COVID-19 Public Health Activities that Require Face-to-Face Interaction with Clients in the Clinic and Field in the Current COVID-19 Pandemic. https://www.cdc.gov/coronavirus/2019-ncov/hcp/non-covid-19-client-interaction.html.
3. Sosa et al. (2019)Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. MMWR 68, 439–443.
4. US CDC. (2010) Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection — United States. MMWR 59 (RR-5), 1.
5. US CDC. (2005) Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005. MMWR 2005; 54 (No. RR-17)

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