University of Illinois College of Medicine at Peoria, USA.
Infect Control Hosp Epidemiol. 2010 Dec;31(12):1279-85. doi: 10.1086/657336. Epub 2010 Oct 27.
The Center for Disease Control and Prevention recommends the use of QuantiFERON TB Gold test (QFTG; Cellestis) in all situations where the tuberculin skin test (TST) is used. In November 2007, our institution replaced its screening-tool TST with the QFTG in-tube assay (QFT-GIT) for annual screening of latent tuberculosis infection among healthcare workers (HCWs). This study evaluated the effectiveness of QFT-GIT test as screening tool in HCWs at our institution.
This retrospective study reviewed medical records of all HCWs who underwent screening with QFT-GIT from January 2008 through December 2008.
Among the 6,530 HCWs screened with QFT-GIT from January through December 2008, 287 had a positive test result. Of the 287, 123 had positive TST results in the past, meaning that 164 HCWs had newly diagnosed latent tuberculosis infection by QFT-GIT. Of the 164 HCWs, 135 were retested by QFT-GIT and were simultaneously tested with TST within 4 weeks after the initial QFT-GIT. Of these 135 HCWs, 66 reverted to negative results and results remained positive for 69 with QFT-GIT. Only 2 HCWs had a positive TST result.
The disagreement between QFT-GIT and TST results and the high reversion rate with QFT-GIT raise concerns about the effectiveness of QFT-GIT as a sole screening test in HCWs.
疾病控制与预防中心建议在所有使用结核菌素皮肤试验（TST）的情况下使用 QuantiFERON TB Gold 试验（QFTG；Cellestis）。2007 年 11 月，我们机构用 QFT-GIT 管内检测法（QFT-GIT）代替 TST 作为筛查工具，用于对医护人员（HCWs）进行年度潜伏性结核感染筛查。本研究评估了 QFT-GIT 试验作为我们机构 HCWs 筛查工具的有效性。
本回顾性研究查阅了 2008 年 1 月至 12 月期间接受 QFT-GIT 筛查的所有 HCWs 的病历。
在 2008 年 1 月至 12 月期间接受 QFT-GIT 筛查的 6530 名 HCWs 中，有 287 名检测结果阳性。在这 287 名中，过去有 123 名 TST 阳性结果，这意味着有 164 名 HCWs 通过 QFT-GIT 新诊断为潜伏性结核感染。在这 164 名 HCWs 中，135 名接受了 QFT-GIT 复测，并且在初次 QFT-GIT 后 4 周内同时接受了 TST 检测。在这 135 名 HCWs 中，66 名转为阴性，69 名仍为 QFT-GIT 阳性。仅有 2 名 HCWs 的 TST 阳性。
QFT-GIT 与 TST 结果之间的不一致以及 QFT-GIT 的高逆转率令人对 QFT-GIT 作为 HCWs 的单一筛查试验的有效性产生了担忧。
