Bruins J, Gribnau J H, Bwire R
Department of Military Health Care, Utrecht, The Netherlands.
Tuber Lung Dis. 1995 Dec;76(6):540-4. doi: 10.1016/0962-8479(95)90531-6.
The Department of Military Health Services (DMGZ) vaccination clinic, Utrecht, The Netherlands.
To improve upon PPD skin testing procedure by introducing a double Mantoux test.
During the first part of the study, from 1986-1988, army recruits were double-tested simultaneously with PPD and Mycobacterium scrofulacaeum sensitin. During the second part of the study, from 1989 to 1993, recruits reacting to PPD, with an induration in the range of 10-15 mm, underwent a second skin test with M. scrofulaceum sensitin. The total study population consisted of 237,692 non-BCG-vaccinated recruits.
From 1986-1993 and average of 0.45% persons reacted with indurations > or = 10 mm to PPD. An average of 7.76% if army recruits reacted with indurations > or = 10 mm to M. scrofulaceum sensitin during the first part of the study. Using a modified ITSC (International Tuberculosis Surveillance Centre) model, 48% of the persons reacting to PPD with indurations in the range 10 mm and 15 mm were classified as false-positive. A total of 16% with indurations > or = 10 mm to PPD were classified as false positive. False-positive persons were then excluded from INH chemoprophlaxis.
In areas with a high prevalence of non-tuberculous mycobacteria infection the use of double skin testing might be useful in differentiating between indurations due to tubercle bacilli and those due to infection with non-tuberculous mycobacteria.
荷兰乌得勒支军事卫生服务部（DMGZ）疫苗接种诊所。
通过引入双重曼托试验改进结核菌素纯蛋白衍生物（PPD）皮肤试验程序。
在研究的第一阶段，即1986年至1988年期间，对新兵同时进行PPD和瘰疬分枝杆菌变应原双重检测。在研究的第二阶段，即1989年至1993年期间，对PPD检测硬结范围在10 - 15毫米的新兵进行第二次瘰疬分枝杆菌变应原皮肤试验。总研究人群包括237,692名未接种卡介苗的新兵。
1986年至1993年期间，平均0.45%的人PPD检测硬结≥10毫米。在研究的第一阶段，平均7.76%的新兵瘰疬分枝杆菌变应原检测硬结≥10毫米。使用改良的国际结核病监测中心（ITSC）模型，PPD检测硬结在10毫米至15毫米范围的人中，48%被归类为假阳性。PPD检测硬结≥10毫米的人中有16%被归类为假阳性。然后将假阳性者排除在异烟肼化学预防之外。
在非结核分枝杆菌感染高发地区，使用双重皮肤试验可能有助于区分结核杆菌引起的硬结和非结核分枝杆菌感染引起的硬结。
