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Infection
Published in: Infection 3/2017

Open Access 01-06-2017 | Original Paper

Risk for latent and active tuberculosis in Germany

Authors: Christian Herzmann, Giovanni Sotgiu, Oswald Bellinger, Roland Diel, Silke Gerdes, Udo Goetsch, Helga Heykes-Uden, Tom Schaberg, Christoph Lange, For the TB or not TB consortium

Published in: Infection | Issue 3/2017

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Abstract

Purpose

Few individuals that are latently infected with M. tuberculosis latent tuberculosis infection(LTBI) progress to active disease. We investigated risk factors for LTBI and active pulmonary tuberculosis (PTB) in Germany.

Methods

Healthy household contacts (HHCs), health care workers (HCWs) exposed to M. tuberculosis and PTB patients were recruited at 18 German centres. Interferon-γ release assay (IGRA) testing was performed. LTBI risk factors were evaluated by comparing IGRA-positive with IGRA-negative contacts. Risk factors for tuberculosis were evaluated by comparing PTB patients with HHCs.

Results

From 2008–2014, 603 HHCs, 295 HCWs and 856 PTBs were recruited. LTBI was found in 34.5% of HHCs and in 38.9% of HCWs. In HCWs, care for coughing patients (p = 0.02) and longstanding nursing occupation (p = 0.04) were associated with LTBI. In HHCs, predictors for LTBI were a diseased partner (odds ratio 4.39), sexual contact to a diseased partner and substance dependency (all p < 0.001). PTB was associated with male sex, low body weight (p < 0.0001), alcoholism (15.0 vs 5.9%; p < 0.0001), glucocorticoid therapy (7.2 vs 2.0%; p = 0.004) and diabetes (7.8 vs. 4.0%; p = 0.04). No contact developed active tuberculosis within 2 years follow-up.

Conclusions

Positive IGRA responses are frequent among exposed HHCs and HCWs in Germany and are poor predictors for the development of active tuberculosis.
Appendix
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Metadata
Title
Risk for latent and active tuberculosis in Germany
Authors
Christian Herzmann
Giovanni Sotgiu
Oswald Bellinger
Roland Diel
Silke Gerdes
Udo Goetsch
Helga Heykes-Uden
Tom Schaberg
Christoph Lange
For the TB or not TB consortium
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Infection / Issue 3/2017
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-016-0963-2

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