국내 의료기관 근무자에서 발생한 활동성 결핵의 양상

Abstract

Background: Healthcare workers are vulnerable to tuberculosis because they are frequently exposed to patients with active tuberculosis. This study aimed to describe the clinical and epidemiological characteristics of active tuberculosis among healthcare workers in a hospital in South Korea. Methods: This retrospective descriptive study included 30 healthcare workers diagnosed with active tuberculosis between 2009 and 2019 in a tertiary hospital in South Korea. We reviewed the medical records for clinical findings and treatment processes. Their baseline characteristics were analyzed based on the presence or absence of symptoms. The risk of developing active tuberculosis by not only occupational groups in the medical field but also high-risk groups with possibility of contact with patients with tuberculosis was evaluated. Results: Female healthcare workers accounted for 83.3% of the participants. The average age was 31.7 years, and the average duration from employment to diagnosis was 52.69 months. Of the subjects, 6.7% had a body mass index of <18.5 kg/m2. Moreover, 86.7% were in the normal weight range. The most frequent symptom was cough for >3 weeks. The acid-fast bacillus (AFB) smear test and AFB culture were performed for all participants. Furthermore, 70% of the samples showed positive culture results. Regarding occupational distribution, the number of nurses was highest at 56%. The majority of healthcare workers worked in high-risk areas, being in contact with patients with tuberculosis. Pulmonary tuberculosis was noted in 25 patients. The other five patients had extrapulmonary tuberculosis. All subjects were treated with primary anti-tuberculosis medications. The average treatment duration was 6 months (66.7%). Conclusion: Healthcare workers who work in areas with possibility of contact with patients with tuberculosis are at high risk of active tuberculosis infection. Therefore, continuous screening and comprehensive tests are required.