《儿童中 QuantiFERON-TB Gold Plus 的性能：一项叙述性综述》。

QuantiFERON-TB Gold Plus Performance in Children: A Narrative Review.

机构信息

From the Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Global Health Research Institute, Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Pediatr Infect Dis J. 2023 May 1;42(5):e158-e165. doi: 10.1097/INF.0000000000003877. Epub 2023 Feb 15.

DOI:10.1097/INF.0000000000003877

PMID:36795574

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10097492/

Abstract

This review summarizes studies evaluating the performance of the QuantiFERON-TB Gold Plus (QFT-Plus) interferon-gamma release assay (IGRA) test for Mycobacterium tuberculosis ( Mtb ) infection in children. Literature searching was conducted using PubMed, MEDLINE and Embase (January 2017 to December 2021) and the terms "children" or "pediatric" and "IGRAs" or "QuantiFERON-TB Gold Plus." Selected studies (N = 14; 4646 subjects) enrolled children with Mtb infection, tuberculosis (TB) disease or healthy children with household TB contacts. Agreement between QFT-Plus and tuberculin skin test (TST) (kappa values) ranged from -0.201 (no agreement) to 0.83 (almost perfect agreement). Assay sensitivity of QFT-Plus (against reference standard of microbiologically confirmed TB disease) was 54.5%-87.3%, with no reported difference in children less than 5 versus greater than or equal to 5 years of age. In individuals less than or equal to 18 years of age, the rate of indeterminate results was 0%-33.3% (2.6% in children <2 years). IGRAs may overcome the limitations of TST in young, Bacillus Calmette-Guérin-vaccinated children.

摘要

这篇综述总结了评估结核分枝杆菌（Mtb）感染的 QuantiFERON-TB Gold Plus（QFT-Plus）干扰素-γ释放试验（IGRA）在儿童中的性能的研究。使用 PubMed、MEDLINE 和 Embase 进行文献检索（2017 年 1 月至 2021 年 12 月），检索词为“儿童”或“儿科”和“IGRAs”或“QuantiFERON-TB Gold Plus”。选择的研究（N=14；4646 例受试者）纳入了患有 Mtb 感染、结核病（TB）疾病或有家庭 TB 接触史的健康儿童。QFT-Plus 与结核菌素皮肤试验（TST）之间的一致性（kappa 值）范围从-0.201（无一致性）到 0.83（几乎完全一致）。QFT-Plus 的检测灵敏度（与微生物学确诊的 TB 疾病的参考标准相比）为 54.5%-87.3%，在小于 5 岁和大于或等于 5 岁的儿童中均未报告差异。在年龄小于或等于 18 岁的个体中，不确定结果的发生率为 0%-33.3%（2 岁以下儿童为 2.6%）。IGRAs 可能克服 TST 在年轻、卡介苗接种儿童中的局限性。