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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)
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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.

Information

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

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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