Nosocomial tuberculosis transmission from 2006 to 2018 in Beijing Chest Hospital, China

Xie, Zhongyao; Zhou, Ning; Chi, Yuqing; Huang, Guofang; Wang, Jingping; Gao, Hui; Xie, Na; Ma, Qianhui; Yang, Nan; Duan, Zhenlan; Nie, Wenjuan; Sun, Zhaogang; Chu, Naihui

INTRODUCTION: Strong evidence is lacking to support effectiveness of currently implemented tuberculosis infection prevention control (TB-IPC) measures for preventing nosocomial tuberculosis (TB) transmission. This 13-year analysis is the longest follow-up investigation to date to identify risk factors underlying nosocomial TB transmission. METHODS: We monitored all staff of Beijing Chest Hospital each year from 2006 to 2018. Age, gender, duration, department, education, income, respirator, ultraviolet, and ventilation were chosen as variables. Univariate cox regression, correlation analysis, and multivariate cox regression were analyzed sequentially. RESULTS: Using multivariable cox regression analysis, variables of income, ultraviolet germicidal irradiation (UVGI), natural ventilation and mechanical ventilation conferred significant protective effects, with odds ratios of 0.499, 0.058, 0.003, and 0.015, respectively (P < 0.05). Medical N95 respirator conferred an excellent protective effect, with an associated TB infection rate of 0%. Notably, inadequately maintained mechanical ventilation systems were less protective than natural ventilation systems. CONCLUSION: UVGI, adequate ventilation, and use of medical N95 respirator may be risk factors of nosocomial TB transmission.