The Dynamic Analysis Of The Status Of Mycobacterium Tuberculosis Infection Among Medical Staff And The Research On The Efficacy Of The New ELISA In The Diagnosis Of Tuberculosis

Objectives:1.To understand the latent infection situation of Mycobacterium tuberculosis(MTB)in health care workers(HCWs)and analyze the related risk factors;2.To provide theoretical support for exploring the control strategy of tuberculosis infection in medical institutions in China and effectively prevents and controls the incidence of tuberculosis in medical staffs.Methods:This study selected the staff of a large tuberculosis hospital in Xinjiang autonomous region as the study objects.After signing the informed consent,each participant completed the questionnaire survey and the gamma interferon release test,obtaining the situation of latent MTB infection among HCWs.Data entry and analysis were performed using EpiData3.1 and SPSS 17.0 software respectively.Risk factors associated with latent tuberculosis infection were determined by monofacterial and multifacterial logistic regeression analysis.The ratio(odd ratio,ORs)and 95%confidence interval(CIs)were used.Results:The latent MTB infection rate in Xinjiang autonomous region lung hospital was 58.6%(194/331)in 2011,and multivariate analysis showed that the service years were related to the latent infection of mycobacterium tuberculosis.Compared with people with a working life of 10 years or less,the risk of infection with mycobacterium tuberculosis was high within people working between 10 and 19 years(95%CI:1.23 3.98;P= 0.007).In 2017,the MTB latent infection rate in TB specialist hospital was 64.8%,and the multi-factor analysis showed that there was a correlation between the place of work and the MTB infection.Compared with medical workers,the risk of MTB infection was low in administrator(OR:0.49;95%CI:0.26 0.91).Of the 186 people included in the study,110 of them was positive for IGRAs in 2011,and 16 of them were negative in 2017,with a negative conversion rate of 14.5%.In 2011,76 was negative for the IGRAs,and 38 of them turned to be positive in 2017 with the positive conservation rate of 50%.Conclusions:1.The latent MTB infection rate of HCWs was higher than general population,and HCWs were the high risk population of latent MTB infection.2.The department of hospital work and the years of working were high risk facters associated with latent MTB infection.3.The positive conservation rate of TB hospital staff was 50%.4.The positive conservation rate of TB hospital staff was 14.5%.In summary,implementation guidelines about TB control in medical institutions should be developed,and we should strengthen TB infection control in tuberculosis hospitals,protecting the health of medical staff.Objective: The aim of this study was to evaluate the value in detecting MTB in sputum of high-sensitivity-ELISA test(HI-ELISA),which is based on detecting the secretory protein MPB64.Methods: 97 pooled sputum specimens from tuberculosis suspected patient were used,then all the sputum samples were subjected to cultivation in Bactec MGIT 960 tubes,Xpert MTB/RIF and HI-ELISA tests respectively,the results of HI-ELISA were compared with 960-liquid-culture results to evaluate the diagnostic efficacy of HI-ELISA.Results: Among the 97 sputum specimens used in current study,the positive rate of MTB in HI-ELISA was 36.08%(35/97)and 32.99%(32/97)respectively.Compared with liquid-culture,the sensitivity of HI-ELISA was 88.57%(31/35),and the specificity of HI-ELISA was 98.39%(61/62),the overall coincidence rate was 94.85%(92/97).Of the 66 sputum specimens with positive-Xpert MTB/RIF-result,34 samples were culture-positive and32 were culture-negative.HI-ELISA results displayed that 32 samples contained MTB and other 34 specimens were free from MTB.Among the 66 Xpert MTB/RIF-positive samples,the sensitivity of HI-ELISA was 91.18%(31/34),and the specificity was 96.88%(31/32),and the coincidence rate was 93.93%(62/66),compared with culture.In the 31 Xpert MTB/RIF-negative samples,MTB was detected out in only one sample through liquid-culture but HI-ELISA failed to detect it,however,the other 30 samples detection results were all matched(liquid-culture VS HI-ELISA)and the coincidence rate was 96.77%(30/31).Conclusion: HI-ELISA test was able to detecting viable Mycobacterium tuberculosis with high sensitivity and specificity,displayed high application value in diagnosing active tuberculosis,it was also useful for evaluating therapeutic regimens.