von Reyn C F, Horsburgh C R, Olivier K N, Barnes P F, Waddell R, Warren C, Tvaroha S, Jaeger A S, Lein A D, Alexander L N, Weber D J, Tosteson A N
Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
Int J Tuberc Lung Dis. 2001 Dec;5(12):1122-8.
Health care workers and medical students in the United States subject to annual tuberculin skin testing.
To use skin testing with Mycobacterium avium sensitin (MAS) to determine contemporary rates of infection with non-tuberculous mycobacteria (NTM) and their effect on reactions to M. tuberculosis purified protein derivative (PPD).
Dual skin testing was performed with PPD and MAS on 784 health care workers and medical students in the northern and southern US. MAS reactions that were > or = 5 mm and also > or = 3 mm larger than the PPD reaction were defined as MAS dominant and due to NTM.
MAS reactions were > or = 5 mm in 40% and > or = 15 mm in 18% of subjects; 95% were MAS dominant. MAS dominant reactions were more common in the south than the north (P < 0.001). PPD reactions were > or = 15 mm in 3% of subjects. PPD reactions > or = 15 mm were more common among males, foreign born subjects and subjects with BCG immunization (all P < 0.001). MAS dominant reactions were found in 82% of subjects with 5-9 mm PPD reactions and 50% with 10-14 mm PPD reactions; these reactions were more common among whites (P = 0.046), US-born (P = 0.038) and subjects without BCG immunization (P = 0.004).
Infections with NTM are responsible for the majority of 5-14 mm PPD reactions among US-born health care workers and medical students subject to annual tuberculin testing.
美国的医护人员和医学生需每年进行结核菌素皮肤试验。
使用鸟分枝杆菌致敏素（MAS）进行皮肤试验，以确定非结核分枝杆菌（NTM）的当代感染率及其对结核分枝杆菌纯化蛋白衍生物（PPD）反应的影响。
对美国北部和南部的784名医护人员和医学生进行PPD和MAS双重皮肤试验。将MAS反应≥5mm且比PPD反应大≥3mm定义为MAS占优反应，归因于NTM。
40%的受试者MAS反应≥5mm，18%的受试者MAS反应≥15mm；95%的反应为MAS占优反应。MAS占优反应在南部比北部更常见（P<0.001）。3%的受试者PPD反应≥15mm。PPD反应≥15mm在男性、外国出生的受试者和接种卡介苗的受试者中更常见（均P<0.001）。在PPD反应为5 - 9mm的受试者中，82%出现MAS占优反应；在PPD反应为10 - 14mm的受试者中，50%出现MAS占优反应；这些反应在白人（P = 0.046）、美国出生的人（P = 0.038）和未接种卡介苗的受试者中更常见（P = 0.004）。
在美国出生的、每年接受结核菌素检测的医护人员和医学生中，NTM感染是导致大多数5 - 14mm PPD反应的原因。
