What steps should be taken when an HCW has had a recent BCG vaccination?
When should the TST be placed? A TST may be placed anytime after a BCG vaccination, but a positive TST result after a recent BCG vaccination can be a false-positive result. QFTG should be used, because the assay test avoids cross reactivity with BCG. • A hospital HCW has not had a TST in 18 months because she was on maternity leave and missed her annual TST. She has been employed at the hospital for the previous 5 years. Is two-step testing necessary on her next skin test date? No, two-step TSTs are needed only to establish a baseline for a specific setting for newly hired HCWs and others who will receive serial TST (e.g., residents or staff of correctional facilities or LTCFs). The HCW should have a single TST or BAMT upon returning to work and should then resume a routine testing schedule on the next normal TST anniversary date. • Should two-step testing be performed in a contact investigation for HCWs who have not had a TST within the preceding 12 months? No, two-step testing should
