[Tuberculosis among healthcare workers in Northern France (2002-2007): descriptive analysis of notified cases and contact tracing]

The regional centre for infection control in northern France (CCLIN Nord) has received 28 notifications of pulmonary tuberculosis cases (PTC) in healthcare workers (HCWs), in 30 healthcare institutions, since the implementation of the French notification system for nosocomial infections.

Method: A descriptive analysis of PTC investigations in healthcare workers was performed over a five-year period using a standardized form.

Results: Smear and culture of bronchial samples were positive for 22 PTC and 15 presented radiological cavities. Overall, 7730 contact patients were selected (91.6 % informed) and 4000 healthcare workers (100 % informed). Eighteen percent of adult contact patients, 75 % of children and 50 % of HCWs were investigated. Latent infection was identified in 34 HCWs, 80 adult patients, and ten children. A prophylactic treatment was prescribed for 692 newborns. Tuberculous disease was identified in one adult patient and two HCWs.

Conclusion: Few cases of tuberculosis infection or disease were diagnosed around HCWs presenting with contagious tuberculosis. The effectiveness of broad information campaigns on exposed HCWs remains hard to assess because of the complexity of tuberculosis infection diagnosis, the high number of lost to follow-up, and the lack of adequate targeting. The role of health care management and occupational medicine remains crucial.