Babayigit Cenk, Ozer Burcin, Ozer Cahit, Inandi Tacettin, Duran Nizami, Gocmen Orhan
Department of Chest Diesases and Tuberculosis, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
Department of Microbiology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
Med Sci Monit. 2014 Mar 29;20:521-9. doi: 10.12659/MSM.889943.
Tuberculin skin test (TST) has been used for years as an aid in diagnosing latent tuberculosis infection (LTBI) but it suffers from a number of well-documented performance and logistic problems. Quantiferon-TB Gold In Tube test (QFT-GIT) has been reported to have better sensitivity and specifity than TST. In this study, it was aimed to compare the performance of a commercial IFN-gamma release assay (QFT-GIT) with TST in the diagnosis of HCWs at risk for latent TB infection in BCG vaccinated population.
Hundred healthy volunteer health care workers were enrolled. All were subjected to TST and QFT-GIT. Results were compared among Health Care Workers (HCWs) groups in terms of profession, workplace, working duration.
TST is affected by previous BCG vaccinations and number of cases with QFT-GIT positivity is increased in accordance with the TST induration diameter range. QFT-GIT result was negative in 17 of 32 TST positive (≥ 15 mm) cases and positive in 4 of 61 cases whose TST diameters are between 6-14 mm, that is attritutable to previous BCG vaccination(s). It was negative in all cases with TST diameters between 0-5 mm. HCWs with positive QFT-GIT results were significantly older than the ones with negative results. Furthermore duration of work was significantly longer in QFT-GIT positive than in negative HCWs.
There was a moderate concordance between QFT-GIT and TST, when TST result was defined as positive with a ≥ 15 mm diameter of induration. We suggest that QFT-GIT can be used as an alternative to TST for detection of LTBI, especially in groups with high risk of LTBI and in population with routine BCG vaccination program.
结核菌素皮肤试验（TST）多年来一直用于辅助诊断潜伏性结核感染（LTBI），但它存在许多已被充分记录的性能和后勤问题。据报道，结核感染T细胞检测（QFT-GIT）比TST具有更高的敏感性和特异性。本研究旨在比较商用γ-干扰素释放试验（QFT-GIT）与TST在诊断接种卡介苗人群中潜伏性结核感染风险医护人员方面的性能。
招募了100名健康的志愿者医护人员。所有人都接受了TST和QFT-GIT检测。根据职业、工作场所、工作时长对医护人员（HCWs）组的结果进行比较。
TST受既往卡介苗接种的影响，QFT-GIT阳性病例数随TST硬结直径范围增加。32例TST阳性（≥15mm）病例中有17例QFT-GIT结果为阴性，61例TST直径在6-14mm之间的病例中有4例QFT-GIT结果为阳性，这归因于既往接种过卡介苗。所有TST直径在0-5mm之间的病例QFT-GIT结果均为阴性。QFT-GIT结果阳性的医护人员明显比结果阴性的医护人员年龄大。此外，QFT-GIT结果阳性的医护人员工作时长明显长于结果阴性的医护人员。
当将TST结果硬结直径≥15mm定义为阳性时，QFT-GIT与TST之间存在中度一致性。我们建议QFT-GIT可作为TST的替代方法用于检测LTBI，尤其是在LTBI高风险人群和常规接种卡介苗的人群中。
