Servei de Microbiologia, Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Carretera del Canyet s/n, 08916 Badalona Barcelona Spain.
Eur Respir J. 2010 Feb;35(2):338-42. doi: 10.1183/09031936.00196608.
The aim of the present study was to determine the role of previous non-tuberculous mycobacteria sensitisation in children as a factor of discordant results between tuberculin skin test (TST) and an in vitro T-cell based assay (T-SPOT.TB; Oxford Immunotec, Oxford, UK). We enrolled 21 non-bacille Calmette-Guérin-vaccinated paediatric patients for suspicious of latent tuberculosis infection (LTBI). These patients yielded a positive TST and a negative T-SPOT.TB. Cells were stimulated with Mycobacterium avium sensitin (having cross-reaction with Mycobacterium intracellulare and Mycobacterium scrofulaceum) and the presence of reactive T-cells was determined by an ex vivo ELISPOT. From the 21 patients, in 10 cases (47.6%), we obtained a positive ELISPOT result after stimulation with M. avium sensitin, in six (28.6%) cases, the result was negative and in the remaining five (23.8%) cases, the result was indeterminate. In conclusion, previous non-tuberculous mycobacteria sensitisation induces false-positive results in the TST for diagnosing LTBI and the use of gamma-interferon tests could avoid unnecessary chemoprophylaxis treatment among a child population.
本研究旨在确定非结核分枝杆菌致敏在儿童中作为结核菌素皮肤试验(TST)与体外基于 T 细胞的检测(T-SPOT.TB;Oxford Immunotec,牛津,英国)结果不一致的因素的作用。我们招募了 21 名疑似潜伏性结核感染(LTBI)的非卡介苗接种儿童患者。这些患者的 TST 呈阳性,T-SPOT.TB 呈阴性。用禽分枝杆菌敏感受体(与胞内分枝杆菌和龟分枝杆菌有交叉反应)刺激细胞,并通过体外 ELISPOT 测定反应性 T 细胞的存在。在 21 例患者中,有 10 例(47.6%)在刺激后获得 M. avium sensitin 阳性 ELISPOT 结果,6 例(28.6%)为阴性,5 例(23.8%)为不确定。总之,非结核分枝杆菌致敏先前诱导 LTBI 诊断的 TST 出现假阳性结果,γ-干扰素检测的应用可以避免儿童人群中不必要的化学预防治疗。