Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T19:05:07.344Z Has data issue: false hasContentIssue false
  • English
  • Français

Questionable Effectiveness of the QuantiFERON-TB Gold Test (Cellestis) as a Screening Tool in Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Sumanth Gandra ,
William S. Scott ,
Vijaya Somaraju ,
Huaping Wang ,
Suzanne Wilton  and
Michelle Feigenbaum
Sumanth Gandra*
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois
William S. Scott
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois OSF St. Francis Medical Center, Peoria, Illinois
Vijaya Somaraju
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois OSF St. Francis Medical Center, Peoria, Illinois
Huaping Wang
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois OSF St. Francis Medical Center, Peoria, Illinois
Suzanne Wilton
Affiliation:
OSF St. Francis Medical Center, Peoria, Illinois
Michelle Feigenbaum
Affiliation:
OSF St. Francis Medical Center, Peoria, Illinois
*
41 Sheridan Drive #1, Shrewsbury, MA 01545, (gandrasatyam@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

The Center for Disease Control and Prevention recommends the use of QuantiFERON TB Gold test (QFTG; Cellestis) in all situations where the tuberculin skin test (TST) is used. In November 2007, our institution replaced its screening-tool TST with the QFTG in-tube assay (QFT-GIT) for annual screening of latent tuberculosis infection among healthcare workers (HCWs). This study evaluated the effectiveness of QFT-GIT test as screening tool in HCWs at our institution.

Methods.

This retrospective study reviewed medical records of all HCWs who underwent screening with QFT-GIT from January 2008 through December 2008.

Results.

Among the 6,530 HCWs screened with QFT-GIT from January through December 2008, 287 had a positive test result. Of the 287, 123 had positive TST results in the past, meaning that 164 HCWs had newly diagnosed latent tuberculosis infection by QFT-GIT. Of the 164 HCWs, 135 were retested by QFT-GIT and were simultaneously tested with TST within 4 weeks after the initial QFT-GIT. Of these 135 HCWs, 66 reverted to negative results and results remained positive for 69 with QFT-GIT. Only 2 HCWs had a positive TST result.

Conclusions.

The disagreement between QFT-GIT and TST results and the high reversion rate with QFT-GIT raise concerns about the effectiveness of QFT-GIT as a sole screening test in HCWs.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 12 , December 2010 , pp. 1279 - 1285
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Menzies, D. What does tuberculin reactivity after Bacille Calmette-Guerin vaccination tell us? Clin Infect Dis 2000;31(suppl 3):S71–S74.Google Scholar
2.Andersen, P, Munk, ME, Pollock, JM, Doherty, TM. Specific immune-based diagnosis of tuberculosis. Lancet 2000;356(9235):1099–1104.CrossRefGoogle ScholarPubMed
3.Centers for Disease Control and Prevention. Tuberculosis (TB). September 29, 2010. http://www.cdc.gov/tb/publications/factsheets/testing/QFT.htm/. Accessed January 29, 2010.Google Scholar
4.Menzies, D, Pai, M, Comstock, G. Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med 2007;146(5):340–354.Google Scholar
5.Mazurek, GH, Jereb, J, LoBue, P, Iademarco, MF, Metchock, B, Vernon, A; Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC). Guidelines for using the QuantiFERON-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR Recomm Rep 2005;54(RR-15):49–55.Google Scholar
6.Nienhaus, A, Schablon, A, Le Bâcle, C, Siano, B, Diel, R. Evaluation of the interferon-γ release assay in healthcare workers. Int Arch Occup Environ Health 2008;81:295–300.CrossRefGoogle ScholarPubMed
7.Harada, N, Nakajima, Y, Higuchi, K, Sekiya, Y, Rothel, J, Mori, T. Screening for tuberculosis infection using whole blood interferon γ and Mantoux testing among Japanese healthcare workers. Infect Control Hosp Epidemiol 2006;27:442–448.Google Scholar
8.Pollock, NR, Campos-Neto, A, Kashino, S, et al.Discordant Quantiferon- TB Gold test results among US healthcare workers with increased risk of latent tuberculosis infection: a problem or solution? Infect Control Hosp Epidemiol 2008;29(9):878–886.CrossRefGoogle ScholarPubMed
9. Diagnosis of Tuberculosis Infection and Disease. Canadian tuberculosis standards. 6th ed. 2007:83–84.Google Scholar
10.Perry, S, Sanchez, L, Yang, S, Agarwal, Z, Hurst, P, Parsonnet, P. Reproducibility of QuantiFERON-TB Gold In-Tube assay. Clin Vaccine Immunol 2008;15(3):425–432.Google Scholar
11.Pai, M, O'Brien, R. Serial testing for tuberculosis: can we make sense of T cell assay conversions and reversions? PLoS Med 2007;4(6):e208.CrossRefGoogle ScholarPubMed
12.de Perio, MA, Tsevat, J, Roselle, GA, Kralovic, SM, Eckman, MH. Cost-effectiveness of interferon gamma release assays vs. tuberculin skin tests in health care workers. Arch Intern Med 2009;169(2):179–187.CrossRefGoogle ScholarPubMed
13.Oxlade, O, Schwartzman, K, Menzies, D. Interferon-gamma release assays and TB screening in high-income countries: a cost-effectiveness analysis. Int J Tuberc Lung Dis 2007;11:16–26.Google Scholar