|Title:||Comparison of the prevalence of latent tuberculosis infection among non-dialysis patients with severe chronic kidney disease, patients receiving dialysis, and the dialysis-unit staff a cross-sectional study||Authors:||Shu C.-C.
|Issue Date:||2015||Publisher:||Public Library of Science||Journal Volume:||10||Journal Issue:||4||Start page/Pages:||e0124104||Source:||PLoS ONE||Abstract:||
Background: Patients with renal failure are vulnerable to tuberculosis, a common worldwide infectious disease. In the growing dialysis population, the risk for tuberculosis among the associated sub-groups is important but unclear. This study investigated latent tuberculosis infection (LTBI) in patients with severe chronic kidney disease (CKD) and among dialysis-unit staff caring for patients on dialysis. Methods: From January 2012 to June 2013, patients undergoing dialysis, those with severe CKD (estimated glomerular filtration rate <30ml/min/1.73 m2), and the dialysis-unit staff (nursing staff and doctors in hemodialysis units) in several Taiwan hospitals were prospectively enrolled. Interferon-gamma release assay (IGRA) through QuantiFERON-TB Gold In-tube was used to determine LTBI. Predictors for LTBI were analyzed. Results: Of the 599 participants enrolled, 106 (25%) in the dialysis group were IGRA positive. This was higher than the seven (11%) among severe CKD patients and 12 (11%) in the dialysis-unit staff. Independent predictors of LTBI in patient with renal dysfunction were old age (odds ratio [OR]: 1.03 [1.01-1.04] per year increment), prior TB lesion on chest radiograph (OR: 2.90 [1.45-5.83]), serum albumin (OR: 2.59 [1.63-4.11] per 1 g/dl increment), and need for dialysis (OR: 2.47, [1.02-5.95]). The QFT-GIT response was similar among the three groups. Malignancy (OR: 4.91 [1.84-13.10]) and low serum albumin level (OR: 0.22 [0.10-0.51], per 1 g/dl decrease) were associated with indeterminate IGRA results. Conclusions: More patients on dialysis have LTBI compared to those with severe CKD and the dialysisunit staff. Old age, prior radiographic TB lesion, high serum albumin, and need for dialysis are predictors of LTBI in patients with renal failure. Patients with severe CKD are a lower priority for LTBI screening. The hemodialysis environment is not a risk for LTBI and dialysisunit staff may be treated as general healthcare workers. ? 2015 Shu et al.
|ISSN:||1932-6203||DOI:||10.1371/journal.pone.0124104||metadata.dc.subject.other:||albumin; adult; age distribution; Article; blood level; chronic kidney disease; controlled study; disease association; disease severity; female; hemodialysis; human; latent tuberculosis; major clinical study; male; medical staff; middle aged; outcome assessment; patient assessment; prediction; prevalence; prospective study; Taiwan; thorax radiography; chronic kidney failure; comparative study; complication; cross-sectional study; health care personnel; interferon gamma release assay; latent tuberculosis; microbiology; multivariate analysis; statistical model; statistics and numerical data; Cross-Sectional Studies; Female; Health Personnel; Humans; Interferon-gamma Release Tests; Latent Tuberculosis; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prevalence; Renal Dialysis; Renal Insufficiency, Chronic; Taiwan
|Appears in Collections:||醫學系|
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