Conversion Rates of an Interferon-γ Release Assay and the Tuberculin Skin Test in the Serial Monitoring of Healthcare Workers

Overview

Journal Infection

Date 2012 Oct 30

PMID 23104257

Citations 6

Authors

S Y Kim

M S Park

Y S Kim

S K Kim

J Chang

Y A Kang

Affiliations

Soon will be listed here.

Abstract

Purpose: Regular monitoring of latent tuberculosis (TB) infection in healthcare workers (HCWs) is recommended, but the view about the effective method and performance of serial monitoring is controversial. The aim of this study was to determine differences in conversion rates according to TB exposure risk using the tuberculin skin test (TST) and the QuantiFERON-TB Gold In-Tube (QFT-GIT), and to evaluate the reproducibility and within-subject variability of the QFT-GIT in South Korea.

Methods: Fifty-three HCWs were grouped according to their risk for TB exposure: group 1, high risk (n = 21); group 2, low risk (n = 32). Baseline and follow-up TSTs and QFT-GITs were performed from June 2009 to July 2011. Enzyme-linked immunosorbent assays (ELISAs) were repeated for the second QFT-GIT and a third QFT-GIT was performed after 8 weeks when discordant results of the second TST and QFT-GIT or a conversion or reversion were observed.

Results: No difference in the QFT-GIT conversion rate was evident between the two groups (15.4 vs. 6.5 %, p = 0.57), and no TST conversion was observed. The rate of QFT-GIT positivity was higher in the high-risk group (first QFT-GIT: 38.1 vs. 3.1 %, p = 0.002; second QFT-GIT: 33.3 vs. 9.4 %, p = 0.039). The re-test reproducibility of QFT-GIT results was high (100 %), and the within-subject results of repetitive QFT-GITs were variable.

Conclusions: Stricter prevention strategies remain necessary in HCWs at high risk of TB exposure, and serial interferon-γ release assays (IGRAs) should be interpreted with caution in HCWs.

Citing Articles

The Prevalence and Risk Factors of Latent Tuberculosis Infection among Health Care Workers Working in a Tertiary Hospital in South Korea.

Park J Tuberc Respir Dis (Seoul). 2018; 81(4):274-280.

PMID: 30238715 PMC: 6148103. DOI: 10.4046/trd.2018.0020.

Serial testing of healthcare workers for latent tuberculosis infection and long-term follow up for development of active tuberculosis.

Park Y, Kim S, Kim J, Park M, Kim Y, Chang J PLoS One. 2018; 13(9):e0204035.

PMID: 30235272 PMC: 6147453. DOI: 10.1371/journal.pone.0204035.

Occupational Risk of Latent Tuberculosis Infection in Health Workers of 14 Military Hospitals.

Yoon C, Oh S, Lee J, Kim M, Seo Y, Yang J J Korean Med Sci. 2017; 32(8):1251-1257.

PMID: 28665059 PMC: 5494322. DOI: 10.3346/jkms.2017.32.8.1251.

Diagnosis and Treatment of Latent Tuberculosis Infection in Healthcare Workers.

Mok J Tuberc Respir Dis (Seoul). 2016; 79(3):127-33.

PMID: 27433172 PMC: 4943896. DOI: 10.4046/trd.2016.79.3.127.

Comparison of the interferon-gamma release assay with the traditional methods for detecting Mycobacterium tuberculosis infection in children.

Zhou J, Kong C, Shi Y, Zhang Z, Yuan Z Medicine (Baltimore). 2014; 93(15):e87.

PMID: 25275527 PMC: 4616289. DOI: 10.1097/MD.0000000000000087.

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