|
 |
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Copyright ©ERS Journals Ltd 2006
Avoiding the effect of BCG vaccination in detecting Mycobacterium tuberculosis infection with a blood test
1 School of Public Health, University of Düsseldorf, Düsseldorf, 2 Division of Immune Cell Analysis, 3 Division of Clinical Infectious Diseases, 5 Division of Mycobacteriology, Research Center Borstel, Borstel, 4 Medical Service, Police Academy Schleswig-Holstein, Eutin, and 6 Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Hamburg, Germany.
CORRESPONDENCE: C. Lange, Medical Clinic, Research Center Borstel, Parkallee 35, 23845 Borstel, Germany. Fax: 49 4537188313. E-mail: clange{at}fz-borstel.de
Keywords: Contact tracing, early secretory antigenic target 6, enzyme-linked immunospot assay, interferon-
, latent tuberculosis infection, tuberculosis
Received: September 12, 2005
Accepted February 7, 2006
Bacille Calmette–Guérin (BCG) vaccination can confound tuberculin skin test (TST) reactions in the diagnosis of latent tuberculosis infection (LTBI).
The TST was compared with a Mycobacterium tuberculosis (MTB)-specific enzyme-linked immunospot (ELISPOT) assay during an outbreak of MTB infection at a police academy in Germany.
Participants were grouped according to their risk of LTBI in close (n = 36) or occasional (n = 333) contacts to the index case. For the TST, the positive response rate was 53% (19 out of 36) among close and 16% (52 out of 333) among occasional contacts. In total, 56 TST-positive contacts (56 out of 71 = 78.9%) and 27 TST-negative controls (27 out of 298 = 9.1%) underwent ELISPOT testing. The odds ratio (OR) of a positive test result across the two groups was 29.2 (95% confidence interval (CI) 3.5–245.0) for the ELISPOT and 19.7 (95% CI 2.0–190.2) for the TST with a 5 mm cut-off. Of 369 contacts, 158 (42.8%) had previously received BCG vaccination. The overall agreement between the TST and the ELISPOT was low, and positive TST reactions were confounded by BCG vaccination (OR 4.8 (95% CI 1.3–18.0)). In contrast, use of a 10-mm induration cut-off for the TST among occasional contacts showed strong agreement between TST and ELISPOT in nonvaccinated persons.
In bacille Calmette–Guérin-vaccinated individuals, the Mycobacterium tuberculosis-specific enzyme-linked immunospot assay is a better indicator for the risk of latent tuberculosis infection than the tuberculin skin test.
This article has been cited by other articles:
|
|
 |
|
  J. Z. Metcalfe, A. Cattamanchi, E. Vittinghoff, C. Ho, J. Grinsdale, P. C. Hopewell, L. M. Kawamura, and P. Nahid Evaluation of Quantitative IFN-{gamma} Response for Risk Stratification of Active Tuberculosis Suspects Am. J. Respir. Crit. Care Med., January 1, 2010; 181(1): 87 - 93. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lange, M. Pai, F. Drobniewski, and G. B. Migliori Interferon-{gamma} release assays for the diagnosis of active tuberculosis: sensible or silly? Eur. Respir. J., June 1, 2009; 33(6): 1250 - 1253. [Full Text] [PDF]
|
|
|
|
|
|
U. Mack, G. B. Migliori, M. Sester, H. L. Rieder, S. Ehlers, D. Goletti, A. Bossink, K. Magdorf, C. Holscher, B. Kampmann, et al. LTBI: latent tuberculosis infection or lasting immune responses to M. tuberculosis? A TBNET consensus statement Eur. Respir. J., May 1, 2009; 33(5): 956 - 973. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Strassburg, C. Jafari, M. Ernst, W. Lotz, and C. Lange Rapid diagnosis of pulmonary TB by BAL enzyme-linked immunospot assay in an immunocompromised host Eur. Respir. J., May 1, 2008; 31(5): 1132 - 1135. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N Viget, G Vernier-Massouille, D Salmon-Ceron, Y Yazdanpanah, and J-F Colombel Opportunistic infections in patients with inflammatory bowel disease: prevention and diagnosis Gut, April 1, 2008; 57(4): 549 - 558. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Palazzo, F. Spensieri, M. Massari, G. Fedele, L. Frasca, S. Carrara, D. Goletti, and C. M. Ausiello Use of Whole-Blood Samples in In-House Bulk and Single-Cell Antigen-Specific Gamma Interferon Assays for Surveillance of Mycobacterium tuberculosis Infections Clin. Vaccine Immunol., February 1, 2008; 15(2): 327 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J-P. Janssens, P. Roux-Lombard, T. Perneger, M. Metzger, R. Vivien, and T. Rochat Quantitative scoring of an interferon-{gamma} assay for differentiating active from latent tuberculosis Eur. Respir. J., October 1, 2007; 30(4): 722 - 728. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Diel, P. Wrighton-Smith, and J-P. Zellweger Cost-effectiveness of interferon-{gamma} release assay testing for the treatment of latent tuberculosis Eur. Respir. J., August 1, 2007; 30(2): 321 - 332. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Lalvani Diagnosing Tuberculosis Infection in the 21st Century: New Tools To Tackle an Old Enemy Chest, June 1, 2007; 131(6): 1898 - 1906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Diel, A. Nienhaus, and R. Loddenkemper Cost-effectiveness of Interferon-{gamma} Release Assay Screening for Latent Tuberculosis Infection Treatment in Germany Chest, May 1, 2007; 131(5): 1424 - 1434. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Jafari, M. Ernst, B. Kalsdorf, U. Greinert, R. Diel, D. Kirsten, K. Marienfeld, A. Lalvani, and C. Lange Rapid Diagnosis of Smear-negative Tuberculosis by Bronchoalveolar Lavage Enzyme-linked Immunospot Am. J. Respir. Crit. Care Med., November 1, 2006; 174(9): 1048 - 1054. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. O. Davies and F. Drobniewski The use of interferon-{gamma}-based blood tests for the detection of latent tuberculosis infection. Eur. Respir. J., July 1, 2006; 28(1): 1 - 3. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |