Evaluation of the tuberculin skin test and the interferon- release assay for TB screening in French healthcare workers

被引：19

作者：

Tripodi D. ^{[1
]}

Brunet-Courtois B. ^{[1
]}

Nael V. ^{[1
]}

Audrain M. ^{[2
]}

Chailleux E. ^{[3
]}

Germaud P. ^{[3
]}

Naudin F. ^{[4
]}

Muller J.-Y. ^{[2
]}

Bourrut-Lacouture M. ^{[1
]}

Durand-Perdriel M.-H. ^{[1
]}

Gordeeff C. ^{[1
]}

Guillaumin G. ^{[1
]}

Houdebine M. ^{[1
]}

Raffi F. ^{[5
]}

Boutoille D. ^{[5
]}

Biron C. ^{[5
]}

Potel G. ^{[6
]}

Roedlich C. ^{[1
]}

Geraut C. ^{[1
]}

Schablon A. ^{[7
]}

Nienhaus A. ^{[7
]}

机构：

[1] Department of Occupational Medicine and Occupational Hazards, University Hospital of Nantes

[2] Department of Immunology, University Hospital of Nantes

[3] Department of Pneumology, Lannec Hospital, University Hospital of Nantes

[4] Tuberculosis Public Health Clinic, Nantes

[5] Department of the Infectious and Tropical Illnesses, Hospital, CHU Nantes

[6] Emergency Department, University Hospital of Nantes

来源：

Journal of Occupational Medicine and Toxicology | / 4卷 / 1期

关键词：

Tuberculin Skin Test; Positive Tuberculin Skin Test; Tuberculin Skin Test Result; Preventive Chemotherapy; French Guideline;

D O I：

10.1186/1745-6673-4-30

中图分类号：

学科分类号：

摘要：

Introduction. Using French cut-offs for the Tuberculin Skin Test (TST), results of the TST were compared with the results of an Interferon- Release Assay (IGRA) in Healthcare Workers (HCW) after contact to AFB-positive TB patients. Methods. Between May 2006 and May 2007, a total of 148 HCWs of the University Hospital in Nantes, France were tested simultaneously with IGRA und TST. A TST was considered to indicate recent latent TB infection (LTBI) if an increase of >10 mm or if TST ≥15 mm for those with no previous TST result was observed. For those with a positive TST, chest X-ray was performed and preventive chemotherapy was offered. Results. All HCWs were BCG-vaccinated. The IGRA was positive in 18.9% and TST 10 mm was observed in 65.5%. A recent LTBI was believed to be highly probable in 30.4% following TST. Agreement between IGRA and TST was low (kappa 0.041). In 10 (16.7%) out of 60 HCWs who needed chest X-ray following TST the IGRA was positive. In 9 (20%) out of 45 HCWs to whom preventive chemotherapy was offered following TST the IGRA was positive. Of those considered TST-negative following the French guidelines, 20.5% were IGRA-positive. In a two-step strategy - positive TST verified by IGRA - 18 out of 28 (64.3%) IGRA-positive HCWs would not have been detected using French guidelines for TST interpretation. Conclusion. The introduction of IGRA in contact tracings of BCG-vaccinated HCWs reduces X-rays and preventive chemotherapies. Increasing the cut-off for a positive TST does not seem to be helpful to overcome the effect of BCG vaccination on TST. © 2009 Tripodi et al; licensee BioMed Central Ltd.

引用

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