Comparison of the interferon-gamma; release assay and the tuberculin skin test for contact investigation of tuberculosis in BCG-vaccinated health care workers

Susan Shin Jung Lee, Yung Ching Liu, Tsi Shu Huang, Yao Shen Chen, Hung Chin Tsai, Shue Ren Wann, Hsi Hsun Lin

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Health care workers are at increased risk of Mycobacterium tuberculosis infection. The tuberculin skin test (TST) is frequently false positive in BCG-vaccinated health care workers. QuantiFERON-TB GOLD (QFT-G) is a sensitive and specific interferon-γ release assay unaffected by BCG vaccination. This study compared TST and QFT-G in the diagnosis of latent TB infection in BCG-vaccinated health care workers. 39 health care workers exposed to a smear-positive TB patient were enrolled. Initial TST was positive in 33 (84.6%) cases, but only 4 (10.2%) cases using QFT-G. TST conversion occurred in 2/6 (33.3%), compared to 4/ 32(12.5%), cases using QFT-G. A higher proportion of QFT converters was associated with intimate contact, although not reaching statistical significance. Face-to-face contact >1 h was significantly associated with QFT-G conversion ≥0.7 IU/ml (OR 8.63,95% 1.08-69.07, p=0.04). Agreement between TST and QFT-G was 18.0%, (κ -0.03). Concordance between TST and QFT (≥0.35 IU/ml) conversion was 40.0%(κ=-0.40), and 60.0%(κ=0.00) if QFT ≥0.7 IU/ml was used. Agreement increased with increasing TST cut-offs. TST is not useful in contact investigation among BCG-vaccinated health care workers, in an area with intermediate burden of TB. QFT may provide additional information for the diagnosis and strategic management of preventive treatment of LTBI in BCG-vaccinated health care workers in a country with intermediate burden of TB.

Original languageEnglish
Pages (from-to)373-380
Number of pages8
JournalScandinavian Journal of Infectious Diseases
Volume40
Issue number5
DOIs
Publication statusPublished - 2008
Externally publishedYes

Fingerprint

Tuberculin Test
Mycobacterium bovis
Skin Tests
Interferon-gamma
Tuberculosis
Delivery of Health Care
Mycobacterium Infections
Mycobacterium tuberculosis
Interferons
Vaccination
Infection

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology

Cite this

Comparison of the interferon-gamma; release assay and the tuberculin skin test for contact investigation of tuberculosis in BCG-vaccinated health care workers. / Lee, Susan Shin Jung; Liu, Yung Ching; Huang, Tsi Shu; Chen, Yao Shen; Tsai, Hung Chin; Wann, Shue Ren; Lin, Hsi Hsun.

In: Scandinavian Journal of Infectious Diseases, Vol. 40, No. 5, 2008, p. 373-380.

Research output: Contribution to journalArticle

Lee, Susan Shin Jung ; Liu, Yung Ching ; Huang, Tsi Shu ; Chen, Yao Shen ; Tsai, Hung Chin ; Wann, Shue Ren ; Lin, Hsi Hsun. / Comparison of the interferon-gamma; release assay and the tuberculin skin test for contact investigation of tuberculosis in BCG-vaccinated health care workers. In: Scandinavian Journal of Infectious Diseases. 2008 ; Vol. 40, No. 5. pp. 373-380.
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