Patients at increased risk for Latent TB Infection (LTBI)

Patients at increased risk for LTBI should be tuberculin skin tested and include the following persons
(Jasmer RM, Nahid P, Hopewell PC. Latent tuberculosis infection. N Engl J Med 2002; 347:1860-1866):

  • Patients at increased risk of exposure to infectious cases:
    • Persons with recent close contact with people known to have active tuberculosis (A close contact is defined as a person with at least 12 hours of contact with a person with infectious TB, but there are no well-established criteria for such contact)
    • Health care workers who work at facilities where patients with TB are treated

  • Patients at increased risk of a TB infection:
    • Foreign-born persons from countries with a high prevalence for TB
    • Homeless persons
    • Persons living or working in facilities providing long-term care

  • Patients at increased risk of active TB once infection has occurred:
    • Persons with a recent TB infection, including:
      • Children less than 4 years of age
      • Patients found to have a tuberculin skin test conversion, defined as an increase of induration of at least 10 mm within a 2-year period
    • Injection-drug users
    • Patients with end-stage renal disease
    • Patients with silicosis
    • Patients with diabetes mellitus
    • Patients receiving immunosuppressive therapy
    • Patients with hematologic cancers
    • Malnourished patients or those with a recent weight loss of more than 10 % of their ideal body weight
    • Patients who have undergone a gastric or jejunoileal bypass

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