Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers.
BACKGROUND:Health care workers (HCWs) are a group at risk of latent tuberculosis infection (LTBI). The aims of this study were to determine IFN-gamma response by QuantiFERON-TB GOLD In Tube (QFN-G-IT) and T-SPOT.TB in HCWs, comparing the results with tuberculin skin test (TST); and to analyze the ca...
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doaj-89dbbd9738fe4701ad02483d249777272020-11-25T00:42:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032009-08-0148e668610.1371/journal.pone.0006686Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers.Irma CasasIrene LatorreMaria EsteveJuan Ruiz-ManzanoDora RodriguezCristina PratIgnasi García-OlivéAlicia LacomaVicente AusinaJose DomínguezBACKGROUND:Health care workers (HCWs) are a group at risk of latent tuberculosis infection (LTBI). The aims of this study were to determine IFN-gamma response by QuantiFERON-TB GOLD In Tube (QFN-G-IT) and T-SPOT.TB in HCWs, comparing the results with tuberculin skin test (TST); and to analyze the capacity of IFN-gamma tests to detect recent versus remote LTBI with a prolonged stimulation test (PST). METHODOLOGY/PRINCIPAL FINDINGS:A total of 147 HCWs were enrolled; 23 of whom were BCG vaccinated. 95 HCWs (64.6%) had a previous positive TST and were not retested; and 52 HCWs had a previous negative TST or were tested for the first time. When we analysed individuals without previous positive TST, the number of positive results for T-SPOT.TB was 12/52 (23.1%); and for QFN-G-IT, 9/52 (17.3%). The global concordance (kappa) between T-SPOT.TB and QFN-G-IT with TST was 0.754 and 0.929 respectively. Of individuals with previous positive TST, T-SPOT.TB and QFN-G-IT were negative in 51.6% (49/95) and 62.1% (59/95) respectively, decreasing the concordance to 0.321 and 0.288, respectively. In non-BCG vaccinated HCWs with previous positive TST a positive IFN-gamma test was associated with degree of exposure and diameter of TST. PST was performed in 24 HCW with previous positive TST and negative IFN-gamma tests. PST was developed in 3 cell cultures stimulated with medium alone, ESAT-6 and CFP-10, respectively. In the third and sixth day of incubation period, part of the supernatants were replaced with complete medium supplemented with (rIL)-2. On day 9, ELISPOT assay was performed. In 14 samples PST was not valid due to not having enough cells. In 8 cases, the response was negative, and in 2 cases positive, suggesting that these patients were infected with Mycobacterium tuberculosis in some point in the past. CONCLUSIONS:Both IFN-gamma tests showed a similar number of positive results, and concordance between the tests was excellent. None of the tests was affected by prior BCG vaccination. IFN-gamma tests are a useful tool for detecting recent infection in HCW population.http://europepmc.org/articles/PMC2726945?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Irma Casas Irene Latorre Maria Esteve Juan Ruiz-Manzano Dora Rodriguez Cristina Prat Ignasi García-Olivé Alicia Lacoma Vicente Ausina Jose Domínguez |
spellingShingle |
Irma Casas Irene Latorre Maria Esteve Juan Ruiz-Manzano Dora Rodriguez Cristina Prat Ignasi García-Olivé Alicia Lacoma Vicente Ausina Jose Domínguez Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers. PLoS ONE |
author_facet |
Irma Casas Irene Latorre Maria Esteve Juan Ruiz-Manzano Dora Rodriguez Cristina Prat Ignasi García-Olivé Alicia Lacoma Vicente Ausina Jose Domínguez |
author_sort |
Irma Casas |
title |
Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers. |
title_short |
Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers. |
title_full |
Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers. |
title_fullStr |
Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers. |
title_full_unstemmed |
Evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers. |
title_sort |
evaluation of interferon-gamma release assays in the diagnosis of recent tuberculosis infection in health care workers. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2009-08-01 |
description |
BACKGROUND:Health care workers (HCWs) are a group at risk of latent tuberculosis infection (LTBI). The aims of this study were to determine IFN-gamma response by QuantiFERON-TB GOLD In Tube (QFN-G-IT) and T-SPOT.TB in HCWs, comparing the results with tuberculin skin test (TST); and to analyze the capacity of IFN-gamma tests to detect recent versus remote LTBI with a prolonged stimulation test (PST). METHODOLOGY/PRINCIPAL FINDINGS:A total of 147 HCWs were enrolled; 23 of whom were BCG vaccinated. 95 HCWs (64.6%) had a previous positive TST and were not retested; and 52 HCWs had a previous negative TST or were tested for the first time. When we analysed individuals without previous positive TST, the number of positive results for T-SPOT.TB was 12/52 (23.1%); and for QFN-G-IT, 9/52 (17.3%). The global concordance (kappa) between T-SPOT.TB and QFN-G-IT with TST was 0.754 and 0.929 respectively. Of individuals with previous positive TST, T-SPOT.TB and QFN-G-IT were negative in 51.6% (49/95) and 62.1% (59/95) respectively, decreasing the concordance to 0.321 and 0.288, respectively. In non-BCG vaccinated HCWs with previous positive TST a positive IFN-gamma test was associated with degree of exposure and diameter of TST. PST was performed in 24 HCW with previous positive TST and negative IFN-gamma tests. PST was developed in 3 cell cultures stimulated with medium alone, ESAT-6 and CFP-10, respectively. In the third and sixth day of incubation period, part of the supernatants were replaced with complete medium supplemented with (rIL)-2. On day 9, ELISPOT assay was performed. In 14 samples PST was not valid due to not having enough cells. In 8 cases, the response was negative, and in 2 cases positive, suggesting that these patients were infected with Mycobacterium tuberculosis in some point in the past. CONCLUSIONS:Both IFN-gamma tests showed a similar number of positive results, and concordance between the tests was excellent. None of the tests was affected by prior BCG vaccination. IFN-gamma tests are a useful tool for detecting recent infection in HCW population. |
url |
http://europepmc.org/articles/PMC2726945?pdf=render |
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