Routine hospital use of a new commercial whole blood interferon-γ assay for the diagnosis of tuberculosis infection
Interferon (IFN)-gamma blood tests may improve the current level of diagnostic accuracy for tuberculosis infection. The QuantiFERON-TB Gold (QFT-Gold) has been used in selected populations and shows higher specificity than the tuberculin skin test (TST). To evaluate the QFT-Gold test in unselected p...
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| Veröffentlicht in: | American journal of respiratory and critical care medicine 2005-09, Vol.172 (5), p.631-635 |
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| creator | FERRARA, Giovanni LOSI, Monica FABBRI, Leonardo M RICHELDI, Luca MEACCI, Marisa MECCUGNI, Barbara PIRO, Roberto ROVERSI, Pietro BERGAMINI, Barbara Maria D'AMICO, Roberto MARCHEGIANO, Patrizia RUMPIANESI, Fabio |
| description | Interferon (IFN)-gamma blood tests may improve the current level of diagnostic accuracy for tuberculosis infection. The QuantiFERON-TB Gold (QFT-Gold) has been used in selected populations and shows higher specificity than the tuberculin skin test (TST).
To evaluate the QFT-Gold test in unselected patients and assess the level of agreement with the TST.
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.
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, chi2 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-Guérin-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).
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. |
| doi_str_mv | 10.1164/rccm.200502-196OC |
| format | Article |
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To evaluate the QFT-Gold test in unselected patients and assess the level of agreement with the TST.
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.
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, chi2 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-Guérin-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).
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.</description><identifier>ISSN: 1073-449X</identifier><identifier>EISSN: 1535-4970</identifier><identifier>DOI: 10.1164/rccm.200502-196OC</identifier><identifier>PMID: 15961696</identifier><language>eng</language><publisher>New York, NY: American Lung Association</publisher><subject>Adult ; Aged ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis ; Diagnostic Tests, Routine - methods ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Feasibility Studies ; Female ; Humans ; Immunoassay - methods ; Intensive care medicine ; Interferon-gamma - blood ; Male ; Medical sciences ; Middle Aged ; Skin Tests ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Tuberculosis - diagnosis</subject><ispartof>American journal of respiratory and critical care medicine, 2005-09, Vol.172 (5), p.631-635</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-7a59c0bb6ca024e836c95843a0f100e89c0f5c3f49dc7ac8bd6d21de2915aa03</citedby><cites>FETCH-LOGICAL-c329t-7a59c0bb6ca024e836c95843a0f100e89c0f5c3f49dc7ac8bd6d21de2915aa03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4011,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17102073$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15961696$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FERRARA, Giovanni</creatorcontrib><creatorcontrib>LOSI, Monica</creatorcontrib><creatorcontrib>FABBRI, Leonardo M</creatorcontrib><creatorcontrib>RICHELDI, Luca</creatorcontrib><creatorcontrib>MEACCI, Marisa</creatorcontrib><creatorcontrib>MECCUGNI, Barbara</creatorcontrib><creatorcontrib>PIRO, Roberto</creatorcontrib><creatorcontrib>ROVERSI, Pietro</creatorcontrib><creatorcontrib>BERGAMINI, Barbara Maria</creatorcontrib><creatorcontrib>D'AMICO, Roberto</creatorcontrib><creatorcontrib>MARCHEGIANO, Patrizia</creatorcontrib><creatorcontrib>RUMPIANESI, Fabio</creatorcontrib><title>Routine hospital use of a new commercial whole blood interferon-γ assay for the diagnosis of tuberculosis infection</title><title>American journal of respiratory and critical care medicine</title><addtitle>Am J Respir Crit Care Med</addtitle><description>Interferon (IFN)-gamma blood tests may improve the current level of diagnostic accuracy for tuberculosis infection. The QuantiFERON-TB Gold (QFT-Gold) has been used in selected populations and shows higher specificity than the tuberculin skin test (TST).
To evaluate the QFT-Gold test in unselected patients and assess the level of agreement with the TST.
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.
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, chi2 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-Guérin-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).
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</subject><subject>Diagnostic Tests, Routine - methods</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Immunoassay - methods</subject><subject>Intensive care medicine</subject><subject>Interferon-gamma - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Skin Tests</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Tuberculosis - diagnosis</subject><issn>1073-449X</issn><issn>1535-4970</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1q3DAURkVpaH4foJuiTbtzcmVbsrUsQ9sEBgZCFtmZa_mqo2JLU0km5LnyHnmmeDIDWele6Xzf4oixrwKuhVD1TTRmui4BJJSF0Gqz-sTOhKxkUesGPi8zNFVR1_rxlJ2n9A9AlK2AL-xUSK2E0uqM5fswZ-eJb0PauYwjnxPxYDlyT0_chGmiaNxy_7QNI_F-DGHgzmeKlmLwxesLx5TwmdsQed4SHxz-9SG5tG_Jc7_E5_F9d96SyS74S3ZicUx0dTwv2MPvXw-r22K9-XO3-rkuTFXqXDQotYG-VwahrKmtlNGyrSsEKwCoXR6tNJWt9WAaNG0_qKEUA5VaSESoLtiPQ-0uhv8zpdxNLhkaR_QU5tSpVgoptV5AcQBNDClFst0uugnjcyeg25vu9qa7g-nu3fSS-XYsn_uJho_EUe0CfD8CmAyONqI3Ln1wjYBy-Z_qDd6lisc</recordid><startdate>20050901</startdate><enddate>20050901</enddate><creator>FERRARA, Giovanni</creator><creator>LOSI, Monica</creator><creator>FABBRI, Leonardo M</creator><creator>RICHELDI, Luca</creator><creator>MEACCI, Marisa</creator><creator>MECCUGNI, Barbara</creator><creator>PIRO, Roberto</creator><creator>ROVERSI, Pietro</creator><creator>BERGAMINI, Barbara Maria</creator><creator>D'AMICO, Roberto</creator><creator>MARCHEGIANO, Patrizia</creator><creator>RUMPIANESI, Fabio</creator><general>American Lung Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050901</creationdate><title>Routine hospital use of a new commercial whole blood interferon-γ assay for the diagnosis of tuberculosis infection</title><author>FERRARA, Giovanni ; LOSI, Monica ; FABBRI, Leonardo M ; RICHELDI, Luca ; MEACCI, Marisa ; MECCUGNI, Barbara ; PIRO, Roberto ; ROVERSI, Pietro ; BERGAMINI, Barbara Maria ; D'AMICO, Roberto ; MARCHEGIANO, Patrizia ; RUMPIANESI, Fabio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-7a59c0bb6ca024e836c95843a0f100e89c0f5c3f49dc7ac8bd6d21de2915aa03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis</topic><topic>Diagnostic Tests, Routine - methods</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Immunoassay - methods</topic><topic>Intensive care medicine</topic><topic>Interferon-gamma - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Skin Tests</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Tuberculosis - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FERRARA, Giovanni</creatorcontrib><creatorcontrib>LOSI, Monica</creatorcontrib><creatorcontrib>FABBRI, Leonardo M</creatorcontrib><creatorcontrib>RICHELDI, Luca</creatorcontrib><creatorcontrib>MEACCI, Marisa</creatorcontrib><creatorcontrib>MECCUGNI, Barbara</creatorcontrib><creatorcontrib>PIRO, Roberto</creatorcontrib><creatorcontrib>ROVERSI, Pietro</creatorcontrib><creatorcontrib>BERGAMINI, Barbara Maria</creatorcontrib><creatorcontrib>D'AMICO, Roberto</creatorcontrib><creatorcontrib>MARCHEGIANO, Patrizia</creatorcontrib><creatorcontrib>RUMPIANESI, Fabio</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of respiratory and critical care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FERRARA, Giovanni</au><au>LOSI, Monica</au><au>FABBRI, Leonardo M</au><au>RICHELDI, Luca</au><au>MEACCI, Marisa</au><au>MECCUGNI, Barbara</au><au>PIRO, Roberto</au><au>ROVERSI, Pietro</au><au>BERGAMINI, Barbara Maria</au><au>D'AMICO, Roberto</au><au>MARCHEGIANO, Patrizia</au><au>RUMPIANESI, Fabio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Routine hospital use of a new commercial whole blood interferon-γ assay for the diagnosis of tuberculosis infection</atitle><jtitle>American journal of respiratory and critical care medicine</jtitle><addtitle>Am J Respir Crit Care Med</addtitle><date>2005-09-01</date><risdate>2005</risdate><volume>172</volume><issue>5</issue><spage>631</spage><epage>635</epage><pages>631-635</pages><issn>1073-449X</issn><eissn>1535-4970</eissn><abstract>Interferon (IFN)-gamma blood tests may improve the current level of diagnostic accuracy for tuberculosis infection. The QuantiFERON-TB Gold (QFT-Gold) has been used in selected populations and shows higher specificity than the tuberculin skin test (TST).
To evaluate the QFT-Gold test in unselected patients and assess the level of agreement with the TST.
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.
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, chi2 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-Guérin-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).
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.</abstract><cop>New York, NY</cop><pub>American Lung Association</pub><pmid>15961696</pmid><doi>10.1164/rccm.200502-196OC</doi><tpages>5</tpages></addata></record> |
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| ispartof | American journal of respiratory and critical care medicine, 2005-09, Vol.172 (5), p.631-635 |
| issn | 1073-449X 1535-4970 |
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| source | Journals@Ovid Ovid Autoload; MEDLINE; American Thoracic Society (ATS) Journals Online; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis Diagnostic Tests, Routine - methods Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Feasibility Studies Female Humans Immunoassay - methods Intensive care medicine Interferon-gamma - blood Male Medical sciences Middle Aged Skin Tests Transfusions. Complications. Transfusion reactions. Cell and gene therapy Tuberculosis - diagnosis |
| title | Routine hospital use of a new commercial whole blood interferon-γ assay for the diagnosis of tuberculosis infection |
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