In South Korea where the tuberculosis (TB) burden is intermediate, the risk of in-hospital transmission of TB remains high. We conducted a retrospective cohort study of 244 inpatients diagnosed with pulmonary TB (2015–2018) to evaluate the impact of the Xpert MTB/RIF assay (Xpert) screening on timely isolation. TB screening was performed with smear microscopy and a polymerase chain reaction test, and the Xpert was additionally used from November 2016. Among all patients with pulmonary TB, the median time-to-isolation was significantly reduced (22.6 vs. 69.7 h; p < 0.001) and segmented regression analysis adjusting for the time trend showed a reduction in time-to-isolation with the introduction of the Xpert (− 39.3 h; 95% CI − 85.6, 7.0; p = 0.096). Among 213 patients who were timely screened (≤ 72 h after admission), time-to-isolation decreased significantly (− 38.2 h; 95% CI − 70.6, − 5.8; p = 0.021) with the introduction of the Xpert, and its decreasing trend continued. The Xpert provided a shorter turnaround time (4.8 vs. 49.1 h; p < 0.001) and higher sensitivity (76.6% vs. 47.8%; p < 0.001) than smear microscopy. Thus, the Xpert can be a useful screening test for pulmonary TB in real-life hospital settings with an intermediate TB burden.
Background: In 2019, there was an outbreak of hepatitis A virus (HAV) infections in Korea. This study was performed to determine the seroprevalence of HAV among healthcare workers (HCWs) in a university-affiliated hospital and to establish an appropriate vaccination strategy against HAV for HCWs. Methods: Total antibody titers to HAV were measured using an electrochemiluminescence immunoassay kit in 1,466 HCWs. The seroprevalence of HAV and HAV vaccination rates in HCWs who were negative for anti-HAV were determined and compared among age and occupational groups. Results: In the whole study population, the seroprevalence of HAV was 49.9%. The seroprevalence was 56.3% in HCWs aged 20-24 years, decreased to 20.9% in those aged 35-39 years, and increased to 100% in those aged 60 years or more. Among HCWs who were seronegative for HAV, 70.6% received HAV vaccination. Among the occupational groups, the vaccination rate was the highest in the nurse group (80.6%) and the lowest in the doctor group (40.2%) (P<0.001). Conclusion: HCWs in their thirties and forties, who demonstrated the lowest seroprevalence of HAV among the age groups, should be prioritized for HAV vaccination. In addition to serologic tests for HAV, interventions to increase vaccination rates should be applied for HCWs, particularly doctors.
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