Goodwin Donald J, Mazurek Gerald H, Campbell Brandon H, Bohanon Jamaria, West Kevin B, Bell James J, Powell Richard, Toney Sean, Morris John A, Yamane Grover K, Sjoberg Paul A
Epidemiology Consult Services, U.S. Air Force School of Aerospace Medicine, 2510 Fifth Street, Building 840, W318K, Wright-Patterson AFB, OH 45433-7913.
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), CDC Mail Stop E-10, 1600 Clifton Road, NE, Atlanta, GA 30333.
Mil Med. 2014 Mar;179(3):333-41. doi: 10.7205/MILMED-D-13-00364.
We automated portions of the QuantiFERON-TB Gold In-Tube test (QFT-GIT) and assessed its quality when performed concurrently with the tuberculin skin test (TST) among U.S. Air Force basic military trainees (BMTs). The volume of blood collected for QFT-GIT was monitored. At least one of the three tubes required for QFT-GIT had blood volume outside the recommended 0.8- to 1.2-mL range for 688 (29.0%) of 2,373 subjects who had their blood collected. Of the 2,124 subjects who had TST and QFT-GIT completed, TST was positive for 0.6%; QFT-GIT was positive for 0.3% and indeterminate for 2.0%. Among 2,081 subjects with completed TST and determinate QFT-GIT results, overall agreement was 99.5% but positive agreement was 5.6%. Specificity among the 1,546 low-risk BMTs was identical (99.7%). Indeterminate QFT-GIT results were 2.7 times more likely when mitogen tubes contained >1.2 mL blood than when containing 0.8- to 1.2-mL blood. Automation can facilitate QFT-GIT completion, especially if the recommended volume of blood is collected. Mycobacterium tuberculosis infection prevalence among BMTs based on TST and QFT-GIT is similar and low. Selectively testing those with significant risk may be more appropriate than universal testing of all recruits.
我们对管内定量干扰素-γ释放试验（QFT-GIT）的部分流程进行了自动化处理，并在美国空军基础军事训练学员（BMT）中，将其与结核菌素皮肤试验（TST）同时进行时评估了其质量。监测了为QFT-GIT采集的血液量。在2373名采集了血液的受试者中，有688名（29.0%）的QFT-GIT所需的三根试管中至少有一根的血量超出了推荐的0.8至1.2毫升范围。在完成TST和QFT-GIT的2124名受试者中，TST阳性率为0.6%；QFT-GIT阳性率为0.3%，不确定率为2.0%。在2081名完成TST且QFT-GIT结果确定的受试者中，总体一致性为99.5%，但阳性一致性为5.6%。1546名低风险BMT的特异性相同（99.7%）。当丝裂原管中的血液量>1.2毫升时，QFT-GIT结果不确定的可能性是血液量在0.8至1.2毫升时的2.7倍。自动化可以促进QFT-GIT的完成，特别是如果采集了推荐量的血液。基于TST和QFT-GIT的BMT中结核分枝杆菌感染患病率相似且较低。对所有新兵进行普遍检测可能不如对有显著风险的人进行选择性检测合适。
