南非对疑似结核病的幼儿进行结核菌素皮肤试验和 QuantiFERON® assay 检测。

Tuberculin skin test and QuantiFERON® assay in young children investigated for tuberculosis in South Africa.

机构信息

South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.

出版信息

Int J Tuberc Lung Dis. 2011 Sep;15(9):1176-81, i. doi: 10.5588/ijtld.10.0770.

DOI:10.5588/ijtld.10.0770

PMID:21943841

Abstract

SETTING

Although the literature on interferon-gamma release assays on tuberculosis (TB) in children has increased, data pertaining to young children remain relatively limited.

OBJECTIVE

To compare results from the tuberculin skin test (TST) and the QuantiFERON®-TB Gold In-Tube assay (QFT) in children aged <3 years investigated for TB disease.

DESIGN

TB suspects were evaluated by medical history and examination, TST, QFT, chest radiography, induced sputum and gastric washings for smear and culture for Mycobacterium tuberculosis.

RESULTS

A total of 400 children were enrolled. Among 397 children with both test results, 68 (17%) were QFT-positive and 72 (18%) were TST-positive (≥10 mm). Agreement between the tests was excellent (94%, κ = 0.79, 95%CI 0.69-0.89). TB disease was diagnosed in 52/397 (13%) participants: 3 definite, 35 probable and 14 possible TB. QFT sensitivity and specificity for TB disease were respectively 38% and 81%. TST sensitivity and specificity were respectively 35% and 84%.

CONCLUSION

While TST and QFT had excellent concordance in this population, both tests had much lower sensitivity for TB disease than has been reported for other age groups. Our results suggested equivalent performance of QFT and TST in the diagnosis of TB disease in young children in a high-burden setting.

摘要

背景

尽管关于儿童结核病（TB）干扰素-γ释放检测的文献不断增加，但针对幼儿的数据仍然相对有限。

目的

比较结核菌素皮肤试验（TST）和 QuantiFERON®-TB Gold In-Tube 检测（QFT）在疑似结核病患儿中的结果。

设计

对疑似结核病患儿进行病史和体格检查、TST、QFT、胸部 X 线检查、诱导痰和胃液涂片及培养检测结核分枝杆菌。

结果

共纳入 400 名患儿。在 397 名具有两种检测结果的患儿中，68 名（17%）QFT 阳性，72 名（18%）TST 阳性（≥10mm）。两种检测方法的一致性极好（94%，κ=0.79，95%CI 0.69-0.89）。52/397 名（13%）患儿诊断为结核病：3 例确诊，35 例可能，14 例可疑。QFT 对结核病的敏感性和特异性分别为 38%和 81%。TST 的敏感性和特异性分别为 35%和 84%。