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QuantiFERON-TB Gold Plus 检测在低结核发病率国家 1-14 岁儿童潜伏性结核感染诊断中的应用。

QuantiFERON-TB Gold Plus Test in Diagnostics of Latent Tuberculosis Infection in Children Aged 1-14 in a Country with a Low Tuberculosis Incidence.

机构信息

Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland.

Mazovian Treatment Centre of Tuberculosis and Lung Diseases, Otwock, Poland.

出版信息

Pol J Microbiol. 2021 Dec;70(4):461-468. doi: 10.33073/pjm-2021-042. Epub 2021 Dec 23.

Abstract

The aim of the study was to evaluate the QuantiFERON-TB Gold Plus (QFT-Plus) test usability in the identification of latent tuberculosis infection (LTBI) in children and the determination of features associated with tuberculin skin test (TST) and QFT-Plus-positive results concerning LTBI. Two-hundred thirteen children aged 1-14 were screened for LTBI due to household contact with TB, suspected TB, or were qualified for biological therapy. The objective of this study was to evaluate the QFT-Plus affectivity as a diagnostic test in the absence of a gold standard (GS) test for the diagnosis of LTBI. The children were diagnosed with QFT-Plus, TST, and culture of TB. The QFT-Plus results were analyzed depending on the children's age, TST size, and type. In children aged 1-4, the positive predictive value of QFT-Plus was 1, the negative predictive value was 0.94, QFT-Plus sensitivity was 75%, and specificity was 100%. It was observed that in children aged 5-14 years, the level of agreement decreased to the substantial, i.e., 87.2%. Moreover, the negative predictive value was 0.83. QFT-Plus sensitivity was 64%, and specificity was 100%. Statistical analysis of QFT-Plus and TST results showed substantial and almost perfect agreements. Our study suggests that QFT-Plus is helpful in a pediatric practice showing good sensitivity and specificity for LTBI. The BCG vaccine, infections, and concomitant morbidities do not affect QFT-Plus results.

摘要

本研究的目的是评估结核感染 T 细胞检测试剂盒(QFT-Plus)在儿童潜伏性结核感染(LTBI)中的可用性,并确定与结核菌素皮肤试验(TST)和 QFT-Plus 阳性结果相关的 LTBI 特征。由于与结核病患者有家庭接触、疑似结核病或有资格接受生物治疗,对 213 名 1-14 岁的儿童进行了 LTBI 筛查。本研究的目的是评估 QFT-Plus 在缺乏 LTBI 诊断金标准(GS)的情况下作为诊断试验的有效性。儿童被诊断为 QFT-Plus、TST 和结核培养阳性。根据儿童的年龄、TST 大小和类型分析 QFT-Plus 的结果。在 1-4 岁的儿童中,QFT-Plus 的阳性预测值为 1,阴性预测值为 0.94,QFT-Plus 的敏感性为 75%,特异性为 100%。观察到在 5-14 岁的儿童中,一致性水平下降到显著水平,即 87.2%。此外,阴性预测值为 0.83。QFT-Plus 的敏感性为 64%,特异性为 100%。对 QFT-Plus 和 TST 结果的统计分析显示,两者之间存在显著且近乎完美的一致性。我们的研究表明,QFT-Plus 在儿科实践中有助于 LTBI 的诊断,具有良好的敏感性和特异性。卡介苗接种、感染和并存的合并症不会影响 QFT-Plus 的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08fd/8702605/c7e75f0f22c4/pjm-70-4-042-g001.jpg

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