scholarly journals False-Positive Tuberculin Skin Test Results Among Low-Risk Healthcare Workers Following Implementation of Fifty-Dose Vials of Purified Protein Derivative

2018 ◽  
Vol 39 (6) ◽  
pp. 750-752 ◽  
Author(s):  
Jeffrey M. Collins ◽  
Mary Hunter ◽  
Wanda Gordon ◽  
Russell R. Kempker ◽  
Henry M. Blumberg ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
False Positive ◽  
Healthcare Workers ◽  
Large Scale ◽  
The United States ◽  
Positive Tuberculin Skin Test ◽  
Low Risk ◽  
Test Results ◽  
Screening Programs

Following large declines in tuberculosis transmission the United States, large-scale screening programs targeting low-risk healthcare workers are increasingly a source of false-positive results. We report a large cluster of presumed false-positive tuberculin skin test results in healthcare workers following a change to 50-dose vials of Tubersol tuberculin.Infect Control Hosp Epidemiol 2018;39:750–752

Negative Tuberculin Skin Test and Prediction of Reversion of QuantiFERON Interferon Gamma Release Assay in US Healthcare Workers

2016 ◽  
Vol 37 (4) ◽  
pp. 478-482 ◽  
Author(s):  
Wendy Thanassi ◽  
Art Noda ◽  
Beatriz Hernandez ◽  
Leah Friedman ◽  
Susan Dorman ◽  
...  
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Interferon Gamma ◽  
Healthcare Workers ◽  
Low Risk ◽  
Infect Control Hosp ◽  
Skin Tests ◽  
Interferon Gamma Release Assay ◽  
Negative Tuberculin Skin Test ◽  
Release Assay

QuantiFERON tuberculosis tests (QFT) reverted in (612) 77% of 1,094 low-risk healthcare workers (HCW) testing less than 1.16 IU/mL. Of HCW testing greater than 1.1 IU/mL, 33 (59%) of 56 with negative tuberculin skin tests (TST) reverted vs 8 (6%) of 125 with positive TSTs. Retesting low-risk QFT-positive and TST-negative HCW is prudent.Infect. Control Hosp. Epidemiol. 2016;37(4):478–482

scholarly journals Kinetics of a Tuberculosis-Specific Gamma Interferon Release Assay in Military Personnel with a Positive Tuberculin Skin Test

2010 ◽  
Vol 17 (6) ◽  
pp. 937-943 ◽  
Author(s):  
Sigrid E. van Brummelen ◽  
Anja M. Bauwens ◽  
Noël J. Schlösser ◽  
Sandra M. Arend
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Military Personnel ◽  
False Positive ◽  
Quantitative Result ◽  
Positive Tuberculin Skin Test ◽  
Gamma Interferon ◽  
Health Care Work ◽  
Release Assay ◽  
Kinetics Of

ABSTRACT Treatment of latent Mycobacterium tuberculosis infection on the basis of the tuberculin skin test (TST) result is inaccurate due to the false-positive TST results that occur after Mycobacterium bovis BCG vaccination or exposure to nontuberculous mycobacteria (NTM). Gamma interferon release assays (IGRAs) are based on M. tuberculosis-specific antigens. In a previous study among BCG-naïve military employees, a positive TST result after deployment was mostly associated with a negative IGRA result, suggesting exposure to NTM. Data regarding the kinetics of IGRAs are limited and controversial. The present study aimed to reassess the rate of false-positive TST results and to evaluate the kinetics of the Quantiferon TB Gold In-Tube assay (QFT-Git) in military personnel with a positive TST result. QFT-Git was performed at the time of inclusion in the study and was repeated after 2, 6, 12, and 18 or 24 months. Of 192 participants, 17 were recruits and 175 were screened after deployment (n = 169) or because of travel or health care work. Baseline positive QFT-Git results were observed in 7/17 (41.2%) and 12/174 (6.9%) participants, respectively. During follow-up, a negative QFT-Git result remained negative in 163/165 (98.8%) participants. Of 18 subjects with an initial positive QFT-Git result, reversion to a negative result occurred in 1/6 (16%) recruits, whereas it occurred in 8/12 (66%) subjects after deployment or with other risk factors (P = 0.046). The quantitative result was significantly lower in subjects with reversion than in those with consistent positive results (P = 0.017). This study confirmed a low rate of positive QFT-Git results among military personnel with a positive TST result after deployment, supporting the hypothesis of exposure to NTM. Reversion of the majority of initially low-positive QFT-Git results indicates that QFT-Git may be useful for the diagnosis of later reinfections.

scholarly journals Comparison of a New ESAT-6/CFP-10 Peptide-Based Gamma Interferon Assay and a Tuberculin Skin Test for Tuberculosis Screening in a Moderate-Risk Population

2006 ◽  
Vol 13 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Emaeil Porsa ◽  
Lee Cheng ◽  
Michael M. Seale ◽  
George L. Delclos ◽  
Xin Ma ◽  
...  
Keyword(s):  
African American ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
The United States ◽  
Gamma Interferon ◽  
Test Results ◽  
Bcg Vaccination ◽  
Ifn Γ ◽  
Foreign Birth ◽  
American Ethnicity

ABSTRACT Screening for latent tuberculosis infection (LTBI) with Mantoux tuberculin skin test (TST) has many limitations, including false-positive results due to exposure to Mycobacterium other than tuberculosis (TB) and BCG vaccination. A total of 474 adult inmates in a county jail were screened for LTBI using TST and a new ESAT-6/CFP-10 peptide-based whole-blood gamma interferon (IFN-γ) assay. LTBI prevalence was 9.0 and 5.4% as determined by TST and IFN-γ assay, respectively. Overall, agreement between test results was 90% (κ = 0.25). Positive TST results were significantly associated with increased age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01 to 1.08), African-American ethnicity (OR, 4.97; 95% CI, 1.58 to 15.68), foreign birth (OR, 20.20; 95% CI, 4.21 to 97.02) and prior incarceration (OR, 6.19; 95% CI, 1.48 to 25.95). Positive IFN-γ assay results were significantly associated with African-American ethnicity (OR, 5.58; 95% CI, 1.16 to 26.74). Factors associated with statistically significant discordance between TST and IFN-γ assay results were African-American ethnicity (OR, 0.29; 95% CI, 0.11 to 0.77), foreign birth (OR, 0.23; 95% CI, 0.07-0.80), and prior incarceration (OR, 0.06; 95% CI, 0.01-0.50). Among subjects born in the United States, African-American ethnicity was the only variable significantly associated with positive test results for both TST (OR, 4.26; 95% CI, 1.38 to 13.16) and IFN-γ assay (OR, 5.74; 95% CI, 1.19 to 27.75) and remained associated with statistically significant discordance between TST and IFN-γ assay results. The reactivity of the new IFN-γ assay is unaffected by prior BCG vaccination or serial TSTs but may be diminished in African-Americans. Future longitudinal studies are needed to assess the sensitivity and specificity of this new assay in detecting LTBI.

Healthcare Worker Knowledge of Measurement and Documentation of Tuberculin Skin Test Reaction

2009 ◽  
Vol 30 (12) ◽  
pp. 1230-1232 ◽  
Author(s):  
Scott H. James ◽  
Juan A. Dumois ◽  
Allison F. Messina ◽  
Jay L. Gould ◽  
David M. Berman
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Healthcare Workers ◽  
Test Results ◽  
Cross Sectional Survey ◽  
Test Reaction ◽  
Cross Sectional ◽  
Inadequate Knowledge ◽  
Tuberculin Skin Test Reaction ◽  
Skin Test Reaction

A cross-sectional survey of 210 healthcare workers at a pediatric teaching hospital was performed to assess knowledge of published guidelines for proper measurement and documentation of tuberculin skin test Results. We conclude that many healthcare workers have inadequate knowledge for optimal measurement and documentation of tuberculin skin test results.

Use and Efficacy of Tuberculosis Infection Control Practices at Hospitals With Previous Outbreaks of Multidrug-Resistant Tuberculosis

2001 ◽  
Vol 22 (7) ◽  
pp. 449-455 ◽  
Author(s):  
Jerome I. Tokars ◽  
George F. McKinley ◽  
Joan Otten ◽  
Charles Woodley ◽  
Emilia M. Sordillo ◽  
...  
Keyword(s):  
Infection Control ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Healthcare Workers ◽  
Multidrug Resistant ◽  
Test Results ◽  
Genetic Typing ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Number Of Patients

AbstractObjective:To evaluate the implementation and efficacy of selected Centers for Disease Control and Prevention guidelines for preventing spread ofMycobacterium tuberculosis.Design:Analysis of prospective observational data.Setting:Two medical centers where outbreaks of multidrug-resistant tuberculosis (TB) had occurred.Participants:All hospital inpatients who had active TB or who were placed in TB isolation and healthcare workers who were assigned to selected wards on which TB patients were treated.Methods:During 1995 to 1997, study personnel prospectively recorded information on patients who had TB or were in TB isolation, performed observations of TB isolation rooms, and recorded tuberculin skin-test results of healthcare workers. Genetic typing ofM tuberculosisisolates was performed by restriction fragment-length polymorphism analysis.Results:We found that only 8.6% of patients placed in TB isolation proved to have TB; yet, 19% of patients with pulmonary TB were not isolated on the first day of hospital admission. Specimens were ordered for acid-fast bacillus smear and results received promptly, and most TB isolation rooms were under negative pressure. Among persons entering TB isolation rooms, 44.2% to 97.1% used an appropriate (particulate, high-efficiency particulate air or N95) respirator, depending on the hospital and year; others entering the rooms used a surgical mask or nothing. We did not find evidence of transmission of TB among healthcare workers (based on tuberculin skin-test results) or patients (based on epidemiological investigation and genetic typing).Conclusions:We found problems in implementation of some TB infection control measures, but no evidence of healthcare-associated transmission, possibly in part because of limitations in the number of patients and workers studied. Similar evaluations should be performed at hospitals treating TB patients to find inadequacies and guide improvements in infection control.

scholarly journals Steroids Decrease Prevalence of Positive Tuberculin Skin Test in Rheumatoid Arthritis: Implications on Anti-TNF Therapies

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Shweta Agarwal ◽  
Siddharth Kumar Das ◽  
Girdhar G. Agarwal ◽  
Ragini Srivastava
Keyword(s):  
Rheumatoid Arthritis ◽  
Tuberculin Skin Test ◽  
Skin Test ◽  
Standard Treatment ◽  
Latent Tuberculosis ◽  
Cross Sectional Study ◽  
Positive Tuberculin Skin Test ◽  
Test Results ◽  
Disease Modifying Antirheumatic Drugs ◽  
Cross Sectional

Tuberculin skin test has been used as an indicator of latent tuberculosis in patients with Rheumatoid Arthritis (RA) before administration of biologicals. Effect of Disease modifying antirheumatic drugs (DMARDs) and steroids on the result of tuberculin skin test (TST) may have important implications in interpretation of results of this test.Objectives. To find the prevalence of positive TST in rheumatoid patients and the effect of standard treatment on the results of TST.Method. In this cross-sectional study two hundred and fifty patients of RA above 18 years of age, classified using 1987 ACR criteria for RA, were enrolled from rheumatology outdoor. Demographics, disease activity, disease duration, and therapy were recorded. All patients underwent TST.Results. Fifty-one (20.4%) patients were found to be tuberculin positive. Tuberculin positivity was not affected by MTX intake but it was significantly low in patients with recent steroid intake as compared to patients who had not taken steroids in last 3 months (3% versus 25%,P= 0.002).Conclusion. Prevalence of tuberculin positivity in patients with RA was found to be low. Results were not affected by methotrexate; however tuberculin skin test results in patients with recent use of steroids are likely to be negative.

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