Contact Tracing for Healthcare Workers Exposed to TB

After the identification of delayed diagnosis, the infection control team collected a list of HCWs suspected of having close contact with patients with TB without protective equipment. A pulmonologist was consulted to determine the proper range of contact investigation, based on clinical information, such as patient’s infectivity, environment, duration, and the procedure involved. HCWs were defined as those having close contacts with a patient infected by TB for more than eight consecutive or 40 cumulative hours, or those who participated in high-risk, aerosol-generating procedures (such as intubation, bronchoscopy, and suctioning) without protection equipment [17 (link)].
It is recommended that close contacts should be performed with chest radiographic and IGRA tests, using QuantiFERON-TB Gold In-Tube assay (Qiagen, Hilden, Germany) two times sequentially, immediately after exposure (baseline) and, then, at 8–10 weeks after exposure. If previous test results existed, chest radiographs within 1 month and IGRA test measurements within 6 months were considered baseline results. When the baseline IGRA result was positive, only a chest radiograph was obtained to rule out active TB. HCWs with a positive IGRA conversion were referred to a pulmonologist to consider active TB or latent TB infection (LTBI) treatment.