Ask the expert: X-rays for TB screening
Q: How often do you need a chest x-ray if you test positive to TB? A staff physician believes he needs to have one every 4-5 years unless he becomes symptomatic. What is the recommendation?
A: CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 provides advice and in this case recommends against repeat x-rays.
The guideline document on p. 30 says that healthcare workers:
“…with a baseline positive or newly positive TST or BAMT result should receive one chest radiograph to exclude a diagnosis of TB disease….After this baseline chest radiograph is performed and the result is documented, repeat radiographs are not needed unless symptoms or signs of TB disease develop or a clinician recommends a repeat chest radiograph.”
In place of serial testing, healthcare workers with positive test results should receive a symptom screening. The frequency of the screening should be determined by the risk classification of the healthcare facility, the guidelines add.
State health department regulations for TB prevention in healthcare facilities may differ from federal guidelines, so it is best to check that your state follows CDC recommendations.
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