Research Article Screening for Tuberculosis in Health Care Workers: Experience in an Italian Teaching Hospital Christian Napoli, 1,2 Filippo Ferretti, 3 Filippo Di Ninno, 3 Riccardo Orioli, 3 Alessandra Marani, 3 Maria Giuditta Sarlo, 1 Claudio Prestigiacomo, 1 Assunta De Luca, 2 and Giovanni Battista Orsi 3 1 Department of Medical Surgical Sciences and Translational Medicine, “Sapienza” University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy 2 Health Direction, University Hospital Sant’Andrea, Via di Grottarossa 1035/1039, 00189 Rome, Italy 3 Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy Correspondence should be addressed to Christian Napoli; christian.napoli@uniroma1.it Received 1 November 2016; Revised 5 February 2017; Accepted 9 February 2017; Published 27 February 2017 Academic Editor: Marija Mostarica-Stojkovi´ c Copyright © 2017 Christian Napoli et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Health care workers (HCW) are particularly at risk of acquiring tuberculosis (TB), even in countries with low TB incidence. Terefore, TB screening in HCW is a useful prevention strategy in countries with both low and high TB incidence. Tuberculin skin test (TST) is widely used although it sufers of low specifcity; on the contrary, the in vitro enzyme immunoassay tests (IGRA) show superior specifcity and sensitivity but are more expensive. Te present study reports the results of a three-year TB surveillance among HCW in a large teaching hospital in Rome, using TST (by standard Mantoux technique) and IGRA (by QuantiFERON-TB) as frst- and second-level screening tests, respectively. Out of 2290 HCW enrolled, 141 (6.1%) had a positive TST; among them, 99 (70.2%) underwent the IGRA and 16 tested positive (16.1%). Te frequency of HCW tested positive for TB seems not far from other experiences in low incidence countries. Our results confrm the higher specifcity of IGRA, but, due to its higher cost, TST can be considered a good frst level screening test, whose positive results should be further confrmed by IGRA before the patients undergo X-ray diagnosis and/or chemotherapy. 1. Introduction Worldwide, 9.6 million people are estimated to have fallen ill with tuberculosis (TB) in 2014 [1]. Moreover, latent TB infection (LTBI) global burden is regularly reported to be approximately one-third of world population [1]. Since people with LTBI are at risk for developing active TB in their lifetime, the World Health Organization (WHO) developed a guidance for managing LTBI, reporting evidence on testing and treatment [2]. With TB incidence rate being considerably below 10 cases per 100,000 inhabitants over the last 10 years, Italy is considered a low-burden country, where specifc population subgroups are afected [3]. Health care workers (HCW) are particularly at risk of acquiring TB in all its forms [4, 5] even in countries with low TB incidence, such as Italy. A meta-analysis estimated that the average annual risk for developing TB disease was threefold higher for HCW (across all settings) compared to the general population [5]. Also, multidrug-resistant TB (MDR-TB) strains are associated with diagnosis delay, less efective treatment, and longer contact periods with infectious patients, increasing their potential transmission to HCW. Consequently, HCW are up to six times more likely to be hospitalized for MDR-TB than the population they care for [6]. Similarly, health care students may present a higher TB infection risk than ordinary popu- lation [7]. Hindawi BioMed Research International Volume 2017, Article ID 7538037, 6 pages https://doi.org/10.1155/2017/7538037