CDC Guidance on TB Screening for US Healthcare Personnel
Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. List the updated CDC recommendations on TB screening for healthcare personnel 2. Discuss postexposure TB screening and testing
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG
President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from 7/1/2019 through 1/25/2023, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
The CDC performed a systematic review of TB screening, specifically for healthcare personnel and have reassessed the need for serial TB testing.
Updated Recommendations Include
TB screening with an individual risk assessment and symptom evaluation at baseline (preplacement)
TB testing with an interferon-gamma release assay (IGRA) or a tuberculin skin test (TST) for persons without documented prior TB disease or latent TB infection (LTBI)
No routine serial TB testing at any interval after baseline in the absence of a known exposure or ongoing transmission
Encouragement of treatment for all health care personnel with untreated LTBI, unless treatment is contraindicated
Annual symptom screening for health care personnel with untreated LTBI
Annual TB education of all health care personnel
Postexposure Screening and Testing (adequate personnel protection was not used)
The updated CDC recommendations are based on a comprehensive systematic review of the literature. TB screening includes TB risk assessment, symptom evaluation and TB testing for M. tuberculosis infection. The CDC also recommends workup for positive TB results or symptoms compatible with TB disease.
Recent data suggest that unlike in previous eras, US health care personnel may not be at increased risk for LTBI and TB disease from occupational exposures
TB rates: 2017 rate has decreased by 73% from 1991 rate and by 42% from 2005
CDC Surveillance data (1995-2007): TB incidence rates among health care personnel were similar to those in the general population
Recent retrospective cohort study (n=40,000) at a tertiary U.S. medical center in a low TB-incidence state found an extremely low rate of TST conversion (0.3%) with most not attributable to occupational exposure
Evidence exists that IGRAs and TSTs have limitations when it comes to serial testing of health care personnel at low risk for LTBI and TB disease
Baseline (preplacement) screening and testing is required to
Provide a basis for comparison in the event of a potential or known exposure to M. tuberculosis
For healthcare personnel with a positive test and who are asymptomatic
If risk assessment is ‘low risk’, follow up with second test (IGRA or TST)
Health care personnel should be considered infected only if both the first and second tests are positive
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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