Epidemiology of tuberculosis among healthcare personnel in New York City

BACKGROUND: We have updated the epidemiology of tuberculosis (TB) among healthcare personnel (HCP) in New York City (NYC), USA, during a period of declining TB burden. METHODS: Using routinely collected Health Department data for NYC TB cases from 2001 to 2014, we conducted a retrospective descriptive analysis. P values were calculated using Pearson's χ 2 or Fisher's exact test for categorical data; Wilcoxon rank-sum test was used to compare medians. We used the Cochran-Armitage test for trend and linear regression for trend analyses. RESULTS: HCP accounted for 6% of adults with TB throughout the study period and were more likely than other adults to be female (68% vs. 37%, P ≤ 0.0001), have extrapulmonary-only disease (31% vs. 23%, P ≤ 0.0001), have an isolate with multidrug resistance (4% vs. 2%, P = 0.0211), and report a previous history of latent TB infection (LTBI) (51% vs. 23%, P ≤ 0.0001). Compared to non-US-born HCP, US-born HCP were more likely to have HIV infection (18% vs. 8%, P = 0.0011) or a genotypically clustered isolate (67% vs. 37%, P ≤ 0.0001) and less likely to report history of prior LTBI (43% vs. 54%, P = 0.0128). CONCLUSIONS: Further research is needed to explore transmission and occupational risk among HCP. New approaches are needed to optimize completion of prophylaxis for HCP with LTBI.