Rationale: Interferon (IFN)-gamma blood tests may improve the current level of diagnostic accuracy for tuberculosis infection. The Quanti-FERON-TB Gold (QFT-Gold) has been used in selected populations and shows higher specificity than the tuberculin skin test (TST). Objective: To evaluate the QFT-Gold test in unselected patients and assess the level of agreement with the TST. Methods: The test has been routinely performed on whole blood samples in our microbiology laboratory for 8 months. Demographic, clinical, and microbiological data have been collected and correlated to the QFT-Gold results. Measurements and Main Results: Of 318 patients tested, 68 (21.4%) gave an indeterminate (low positive mitogen control) QFT-Gold result. Indeterminate results were significantly overrepresented in patients with a negative TST (28.9% vs. 6.6% in TST-positive patients; p < 0.0001, chi(2) test) and were more frequent in patients receiving immunosuppressive therapies than in those who were not receiving such treatments (odds ratio, 3.35; 95% confidence interval, 1.84-6.08; p < 0.0001). After excluding indeterminate results, the concordance between QFT-Gold and TST was significantly lower in Bacille Calmette-Guerin-vaccinated individuals (41.5%) than in nonvaccinated individuals (80.3%) (p < 0.0001). In 11 patients with active tuberculosis (5 culture-confirmed), QFT-Gold provided more positive results than the TST (66.7% vs. 33.3%; p = 0.165). Conclusions: The QFT-Gold test is feasible in routine hospital use for the diagnosis of tuberculosis infection. As with the TST, immunosuppression may negatively affect the test's performance, with a significant rate of indeterminate results in the most vulnerable population.

Routine hospital use of a new commercial whole blood interferon-gamma assay for the diagnosis of tuberculosis infection / Ferrara, G; Losi, M; Meacci, M; Meccugni, B; Piro, R; Roversi, P; Bergamini, Barbara Maria; D'Amico, Roberto; Marchegiano, P; Rumpianesi, F; Fabbri, Lm; Richeldi, Luca. - In: AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. - ISSN 1535-4970. - STAMPA. - 172(5):(2005), pp. 631-635.

Routine hospital use of a new commercial whole blood interferon-gamma assay for the diagnosis of tuberculosis infection

BERGAMINI, Barbara Maria;D'AMICO, Roberto;RICHELDI, Luca
2005

Abstract

Rationale: Interferon (IFN)-gamma blood tests may improve the current level of diagnostic accuracy for tuberculosis infection. The Quanti-FERON-TB Gold (QFT-Gold) has been used in selected populations and shows higher specificity than the tuberculin skin test (TST). Objective: To evaluate the QFT-Gold test in unselected patients and assess the level of agreement with the TST. Methods: The test has been routinely performed on whole blood samples in our microbiology laboratory for 8 months. Demographic, clinical, and microbiological data have been collected and correlated to the QFT-Gold results. Measurements and Main Results: Of 318 patients tested, 68 (21.4%) gave an indeterminate (low positive mitogen control) QFT-Gold result. Indeterminate results were significantly overrepresented in patients with a negative TST (28.9% vs. 6.6% in TST-positive patients; p < 0.0001, chi(2) test) and were more frequent in patients receiving immunosuppressive therapies than in those who were not receiving such treatments (odds ratio, 3.35; 95% confidence interval, 1.84-6.08; p < 0.0001). After excluding indeterminate results, the concordance between QFT-Gold and TST was significantly lower in Bacille Calmette-Guerin-vaccinated individuals (41.5%) than in nonvaccinated individuals (80.3%) (p < 0.0001). In 11 patients with active tuberculosis (5 culture-confirmed), QFT-Gold provided more positive results than the TST (66.7% vs. 33.3%; p = 0.165). Conclusions: The QFT-Gold test is feasible in routine hospital use for the diagnosis of tuberculosis infection. As with the TST, immunosuppression may negatively affect the test's performance, with a significant rate of indeterminate results in the most vulnerable population.
172(5)
631
635
Routine hospital use of a new commercial whole blood interferon-gamma assay for the diagnosis of tuberculosis infection / Ferrara, G; Losi, M; Meacci, M; Meccugni, B; Piro, R; Roversi, P; Bergamini, Barbara Maria; D'Amico, Roberto; Marchegiano, P; Rumpianesi, F; Fabbri, Lm; Richeldi, Luca. - In: AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. - ISSN 1535-4970. - STAMPA. - 172(5):(2005), pp. 631-635.
Ferrara, G; Losi, M; Meacci, M; Meccugni, B; Piro, R; Roversi, P; Bergamini, Barbara Maria; D'Amico, Roberto; Marchegiano, P; Rumpianesi, F; Fabbri, Lm; Richeldi, Luca
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/721860
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