Diagnostic utility of QuantiFERON–TB Gold In-Tube test in pediatric tuberculosis disease in Taiwanese children

Kin Sun Wong, Yen Chun Huang, Han Chung Hu, Yhu Chering Huang, Chang Hui Wen, Tzou Yien Lin

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose To compare the performance of a commercial interferon-gamma release assay, QuantiFERON TB Gold-in-Tube (QFG-IT) with the tuberculin skin test (TST) in Taiwanese children for the diagnosis of active tuberculosis (TB). Methods A retrospective chart analysis of pediatric patients (<18 years of age) who underwent QFG-IT tests and TST for the confirmation of active TB between January 2008 and June 2014. Results The sensitivity of QFG-IT was 100% [95% confidence interval (CI): 63.1–100], versus sensitivity of 62.5% for TST (95% CI 24.5–91.5). The positive predictive value of QFG-IT was 100 (95% CI: 89.7–100), while the negative predictive value for TST was 86.9% (95% CI: 67–96.3). Among three patients with Bacillus Calmette–Guérin (BCG) osteitis, two patients with TST were positive, but all tested samples for QFG-IT were negative. Conclusion QFG-IT assay was more sensitive for the diagnosis of TB disease than TST in an intermediate burden population with universal neonatal BCG vaccination. The increased recognition of BCG induced osteitis in recent years has alerted physicians that BCG induced lesions should be suspected when TST is positive but QFG-IT is negative. Despite higher costs for QFG-IT than TST, they have additional value for the diagnosis of active TB and should be performed when a diagnosis of TB remains in doubt.

Original languageEnglish
Pages (from-to)349-354
Number of pages6
JournalJournal of Microbiology, Immunology and Infection
Volume50
Issue number3
DOIs
Publication statusPublished - Jun 1 2017
Externally publishedYes

Fingerprint

Tuberculin Test
Skin Tests
Gold
Tuberculosis
Pediatrics
Bacillus
Confidence Intervals
Osteitis
Interferon-gamma Release Tests
Vaccination
Physicians
Costs and Cost Analysis

Keywords

  • children
  • QFG-IT
  • tuberculin skin test

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Diagnostic utility of QuantiFERON–TB Gold In-Tube test in pediatric tuberculosis disease in Taiwanese children. / Wong, Kin Sun; Huang, Yen Chun; Hu, Han Chung; Huang, Yhu Chering; Wen, Chang Hui; Lin, Tzou Yien.

In: Journal of Microbiology, Immunology and Infection, Vol. 50, No. 3, 01.06.2017, p. 349-354.

Research output: Contribution to journalArticle

Wong, Kin Sun ; Huang, Yen Chun ; Hu, Han Chung ; Huang, Yhu Chering ; Wen, Chang Hui ; Lin, Tzou Yien. / Diagnostic utility of QuantiFERON–TB Gold In-Tube test in pediatric tuberculosis disease in Taiwanese children. In: Journal of Microbiology, Immunology and Infection. 2017 ; Vol. 50, No. 3. pp. 349-354.
@article{a94174a4b99f41d888b30441222ab9b1,
title = "Diagnostic utility of QuantiFERON–TB Gold In-Tube test in pediatric tuberculosis disease in Taiwanese children",
abstract = "Purpose To compare the performance of a commercial interferon-gamma release assay, QuantiFERON TB Gold-in-Tube (QFG-IT) with the tuberculin skin test (TST) in Taiwanese children for the diagnosis of active tuberculosis (TB). Methods A retrospective chart analysis of pediatric patients (<18 years of age) who underwent QFG-IT tests and TST for the confirmation of active TB between January 2008 and June 2014. Results The sensitivity of QFG-IT was 100{\%} [95{\%} confidence interval (CI): 63.1–100], versus sensitivity of 62.5{\%} for TST (95{\%} CI 24.5–91.5). The positive predictive value of QFG-IT was 100 (95{\%} CI: 89.7–100), while the negative predictive value for TST was 86.9{\%} (95{\%} CI: 67–96.3). Among three patients with Bacillus Calmette–Gu{\'e}rin (BCG) osteitis, two patients with TST were positive, but all tested samples for QFG-IT were negative. Conclusion QFG-IT assay was more sensitive for the diagnosis of TB disease than TST in an intermediate burden population with universal neonatal BCG vaccination. The increased recognition of BCG induced osteitis in recent years has alerted physicians that BCG induced lesions should be suspected when TST is positive but QFG-IT is negative. Despite higher costs for QFG-IT than TST, they have additional value for the diagnosis of active TB and should be performed when a diagnosis of TB remains in doubt.",
keywords = "children, QFG-IT, tuberculin skin test",
author = "Wong, {Kin Sun} and Huang, {Yen Chun} and Hu, {Han Chung} and Huang, {Yhu Chering} and Wen, {Chang Hui} and Lin, {Tzou Yien}",
year = "2017",
month = "6",
day = "1",
doi = "10.1016/j.jmii.2015.07.012",
language = "English",
volume = "50",
pages = "349--354",
journal = "Journal of Microbiology, Immunology and Infection",
issn = "0253-2662",
publisher = "Elsevier Taiwan LLC",
number = "3",

}

TY - JOUR

T1 - Diagnostic utility of QuantiFERON–TB Gold In-Tube test in pediatric tuberculosis disease in Taiwanese children

AU - Wong, Kin Sun

AU - Huang, Yen Chun

AU - Hu, Han Chung

AU - Huang, Yhu Chering

AU - Wen, Chang Hui

AU - Lin, Tzou Yien

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Purpose To compare the performance of a commercial interferon-gamma release assay, QuantiFERON TB Gold-in-Tube (QFG-IT) with the tuberculin skin test (TST) in Taiwanese children for the diagnosis of active tuberculosis (TB). Methods A retrospective chart analysis of pediatric patients (<18 years of age) who underwent QFG-IT tests and TST for the confirmation of active TB between January 2008 and June 2014. Results The sensitivity of QFG-IT was 100% [95% confidence interval (CI): 63.1–100], versus sensitivity of 62.5% for TST (95% CI 24.5–91.5). The positive predictive value of QFG-IT was 100 (95% CI: 89.7–100), while the negative predictive value for TST was 86.9% (95% CI: 67–96.3). Among three patients with Bacillus Calmette–Guérin (BCG) osteitis, two patients with TST were positive, but all tested samples for QFG-IT were negative. Conclusion QFG-IT assay was more sensitive for the diagnosis of TB disease than TST in an intermediate burden population with universal neonatal BCG vaccination. The increased recognition of BCG induced osteitis in recent years has alerted physicians that BCG induced lesions should be suspected when TST is positive but QFG-IT is negative. Despite higher costs for QFG-IT than TST, they have additional value for the diagnosis of active TB and should be performed when a diagnosis of TB remains in doubt.

AB - Purpose To compare the performance of a commercial interferon-gamma release assay, QuantiFERON TB Gold-in-Tube (QFG-IT) with the tuberculin skin test (TST) in Taiwanese children for the diagnosis of active tuberculosis (TB). Methods A retrospective chart analysis of pediatric patients (<18 years of age) who underwent QFG-IT tests and TST for the confirmation of active TB between January 2008 and June 2014. Results The sensitivity of QFG-IT was 100% [95% confidence interval (CI): 63.1–100], versus sensitivity of 62.5% for TST (95% CI 24.5–91.5). The positive predictive value of QFG-IT was 100 (95% CI: 89.7–100), while the negative predictive value for TST was 86.9% (95% CI: 67–96.3). Among three patients with Bacillus Calmette–Guérin (BCG) osteitis, two patients with TST were positive, but all tested samples for QFG-IT were negative. Conclusion QFG-IT assay was more sensitive for the diagnosis of TB disease than TST in an intermediate burden population with universal neonatal BCG vaccination. The increased recognition of BCG induced osteitis in recent years has alerted physicians that BCG induced lesions should be suspected when TST is positive but QFG-IT is negative. Despite higher costs for QFG-IT than TST, they have additional value for the diagnosis of active TB and should be performed when a diagnosis of TB remains in doubt.

KW - children

KW - QFG-IT

KW - tuberculin skin test

UR - http://www.scopus.com/inward/record.url?scp=84940988354&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940988354&partnerID=8YFLogxK

U2 - 10.1016/j.jmii.2015.07.012

DO - 10.1016/j.jmii.2015.07.012

M3 - Article

C2 - 26362753

AN - SCOPUS:84940988354

VL - 50

SP - 349

EP - 354

JO - Journal of Microbiology, Immunology and Infection

JF - Journal of Microbiology, Immunology and Infection

SN - 0253-2662

IS - 3

ER -