Tuberculin Skin Test Results and the Booster Phenomenon in Two-Step Tuberculin Skin Testing in Hemodialysis Patients

At the time of hire, 4059 of 6522 healthcare workers required a 2-step tuberculin skin test; 114 workers (2.8%) demonstrated a boosted reaction after the second step. Boosted reactions were significantly associated with male sex and older age. A verbal history of previous tuberculin skin test results was not a reliable indicator of baseline tuberculin skin test status at the time of hire.

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Effectiveness of Two-Step Tuberculin Skin Testing in Hospital Employees

Journal of Pharmacy Technology ◽

10.1177/875512259701300611 ◽

1997 ◽

Vol 13 (6) ◽

pp. 248-251

Author(s):

Jennifer H Tran ◽

John D Seeger

Keyword(s):

Tuberculin Skin Test ◽

Skin Test ◽

English Language ◽

Skin Testing ◽

Tuberculin Skin Testing ◽

Health Administration ◽

Test Reaction ◽

Hospital Employees ◽

English Language Journal ◽

Tuberculin Testing

Objective: To review the literature discussing the use of two-step tuberculin skin testing for hospital employees. Data Sources: English-language journal articles involving human subjects. Study Selection: Selected articles describing the use of two-step tuberculin skin testing. Data Extraction: Information relevant to the topic was extracted from the articles and synthesized into this report. Data Synthesis: People infected with tuberculosis exhibit a skin-test reaction to tuberculin, but this reaction can diminish over time. A two-step tuberculin skin test involves the administration of a second injection of tuberculin 1–3 weeks after the initial injection. The rationale for the use of the two-step tuberculin skin test is to help differentiate between individuals with new tuberculosis infections and those with previous infections whose immune response to tuberculin had decreased to levels not detectable with a single skin test. Conclusions: Two-step tuberculin skin testing is effective at detecting a booster effect. Despite the recent mandate by the Occupational Safety and Health Administration to use two-step tuberculin testing in all healthcare facilities, such testing may not be cost-effective in institutions with young employees, high employee turnover, and a low risk of tuberculosis. The requirements for universal two-step tuberculin testing may need to be reevaluated to account for these factors.

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Temporal dynamics of intradermal cytokine response to tuberculin in Mycobacterium bovis BCG-vaccinated cattle using sampling microneedles

Scientific Reports ◽

10.1038/s41598-021-86398-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sabine Steinbach ◽

Sasan Jalili-Firoozinezhad ◽

Sreenidhi Srinivasan ◽

Mariane B. Melo ◽

Sonya Middleton ◽

...

Keyword(s):

Tuberculin Skin Test ◽

Skin Test ◽

Mycobacterium Bovis ◽

Temporal Dynamics ◽

Skin Testing ◽

Tuberculin Skin Testing ◽

Cytokines And Chemokines ◽

Skin Response ◽

Novel Biomarkers

AbstractBovine tuberculosis (bTB) is a disease of livestock with severe and worldwide economic, animal welfare and zoonotic consequences. Application of test-and-slaughter-based control polices reliant on tuberculin skin testing has been the mainstay of bTB control in cattle. However, little is known about the temporal development of the bovine tuberculin skin test response at the dermal sites of antigen injection. To fill this knowledge gap, we applied minimally-invasive sampling microneedles (SMNs) for intradermal sampling of interstitial fluid at the tuberculin skin test sites in Mycobacterium bovis BCG-vaccinated calves and determined the temporal dynamics of a panel of 15 cytokines and chemokines in situ and in the peripheral blood. The results reveal an orchestrated and coordinated cytokine and local chemokine response, identified IL-1RA as a potential soluble biomarker of a positive tuberculin skin response, and confirmed the utility of IFN-γ and IP-10 for bTB detection in blood-based assays. Together, the results highlight the utility of SMNs to identify novel biomarkers and provide mechanistic insights on the intradermal cytokine and chemokine responses associated with the tuberculin skin test in BCG-sensitized cattle.

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Cutaneous Anergy in Pregnant and Nonpregnant Women With Human Immunodeficiency Virus

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s1064744998000040 ◽

1998 ◽

Vol 6 (1) ◽

pp. 13-17 ◽

Cited By ~ 6

Author(s):

N. L. Eriksen ◽

A. W. Helfgott

Keyword(s):

Human Immunodeficiency Virus ◽

Skin Test ◽

T Lymphocyte ◽

Lymphocyte Count ◽

Skin Testing ◽

The Other ◽

Tuberculin Skin Testing ◽

Test Results ◽

Significant Difference ◽

Immunodeficiency Virus

Objective:To determine the prevalence of cutaneous anergy in pregnant and nonpregnant women who are seropositive for human immunodeficiency virus.Methods and materials:The medical records of 159 women seropositive for human immunodeficiency virus were reviewed. Demographic characteristics and tuberculin skin test results were abstracted from the chart. Tuberculin skin testing was performed by the Mantoux method (5 tuberculin units of purified protein derivative injected intradermally). Anergy testing was performed using any two of the three following antigens; tetanus toxoid, mumps, orCandidaskin test antigen. A positive tuberculin test was defined as induration of 5 mm or more, and a positive test for the other antigens was defined as any amount of induration over the skin test area. Anergy was defined as any amount of induration to the other antigens. A CD4+T lymphocyte count was obtained at the time of skin testing. Continuous variables were analyzed using the Mann Whitney—U test. Categorical data were analyzed with the chi-square or Fisher's exact test as appropriate. A two-tailedPvalue <0.05 was considered significant.Results:There were 102 nonpregnant and 57 pregnant women who returned to have their skin test results read. There was no significant difference in the prevalence of positive, negative or anergic skin test results between groups. The CD4+T lymphocyte count (mean ± standard deviation) in patients with anergic results was similar between pregnant (375 ± 256/mm3) and nonpregnant (358 ± 305/mm3) women (P= 0.64).Conclusion:The prevalence of cutaneous anergy is similar among pregnant and nonpregnant women seropositive for human immunodeficiency virus.

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Interferon-Gamma Release Assays versus Tuberculin Skin Testing for the Diagnosis of Latent Tuberculosis Infection: An Overview of the Evidence

Pulmonary Medicine ◽

10.1155/2013/601737 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 44

Author(s):

A. Trajman ◽

R. E. Steffen ◽

D. Menzies

Keyword(s):

Tuberculin Skin Test ◽

Skin Test ◽

Interferon Gamma ◽

Clinical Evidence ◽

Skin Testing ◽

Latent Tuberculosis ◽

Preventive Therapy ◽

Tuberculin Skin Testing ◽

Interferon Gamma Release Assays ◽

Definition Of

A profusion of articles have been published on the accuracy and uses of interferon-gamma releasing assays. Here we review the clinical applications, advantages, and limitations of the tuberculin skin test and interferon-gamma release assays and provide an overview of the most recent systematic reviews conducted for different indications for the use of these tests. We conclude that both tests are accurate to detect latent tuberculosis, although interferon-gamma release assays have higher specificity than tuberculin skin testing in BCG-vaccinated populations, particularly if BCG is received after infancy. However, both tests perform poorly to predict risk for progression to active tuberculosis. Interferon-gamma release assays have significant limitations in serial testing because of spontaneous variability and lack of a validated definition of conversion and reversion, making it difficult for clinicians to interpret changes in category (conversions and reversions). So far, the most important clinical evidence, that is, that isoniazid preventive therapy reduces the risk for progression to disease, has been produced only in tuberculin skin test-positive individuals.

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The Hymenoptera venom study II: Skin test results and safety of venom skin testing

Journal of Allergy and Clinical Immunology ◽

10.1016/0091-6749(89)90396-5 ◽

1989 ◽

Vol 84 (6) ◽

pp. 967-974 ◽

Cited By ~ 35

Author(s):

R LOCKEY ◽

P TURKELTAUB ◽

C OLIVE ◽

I BAIRDWARREN ◽

E OLIVE ◽

...

Keyword(s):

Skin Test ◽

Skin Testing ◽

Test Results ◽

Hymenoptera Venom

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The Compability Level of Tuberculin Skin Test and T-SPOT.TB, Sensitivity and Spesifisity of T-SPOT.TB in Detecting Latent Tuberculosis in Hemodialysis Patients

Jurnal Respirologi Indonesia ◽

10.36497/jri.v41i1.159 ◽

2021 ◽

Vol 41 (1) ◽

pp. 19-27

Author(s):

Astuti Setyawati ◽

Reviono Reviono ◽

Wachid Putranto

Keyword(s):

Tuberculin Skin Test ◽

Skin Test ◽

Latent Tuberculosis ◽

Hemodialysis Patients

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Development of a Human Gamma Interferon Enzyme Immunoassay and Comparison with Tuberculin Skin Testing for Detection ofMycobacterium tuberculosis Infection

Clinical and Diagnostic Laboratory Immunology ◽

10.1128/cdli.5.4.531-536.1998 ◽

1998 ◽

Vol 5 (4) ◽

pp. 531-536 ◽

Cited By ~ 45

Author(s):

Nuket Desem ◽

Stephen L. Jones

Keyword(s):

Enzyme Immunoassay ◽

Skin Test ◽

Skin Testing ◽

Gamma Interferon ◽

Tuberculin Skin Testing ◽

In Vitro Test ◽

Detection Range ◽

Ifn Γ

ABSTRACT A sensitive two-step simultaneous enzyme immunoassay (EIA) for human gamma interferon (IFN-γ) has been developed and used as an in vitro test for human tuberculosis (TB) in comparison with tuberculin skin testing. The EIA was shown to be highly sensitive, detecting less than 0.5 IU of recombinant human IFN-γ per ml within a linear detection range of 0.5 to 150 IU/ml. The assay was highly reproducible and specific for native IFN-γ. In addition, the assay detected chimpanzee, orangutan, gibbon, and squirrel monkey IFN-γs. Cross-reactions with other human cytokines or with IFN-γs derived from mice, cattle, or Old World monkeys were not evident. The assay was used to detect TB infection by incubating whole blood overnight with human, avian, and bovine tuberculin purified protein derivatives (PPDs), as well as positive (mitogen)- and negative-control preparations. The levels of IFN-γ in plasma supernatants were then determined. Blood from 10 tuberculin skin test-positive individuals responded predominantly to the human tuberculin PPD antigen and to a lesser extent to bovine and avian PPD antigens. By contrast, blood from 10 skin test-negative individuals showed minimal responses or no response to any of the tuberculin PPDs. Detectable levels of IFN-γ were present in all blood samples stimulated with mitogen. In vivo tuberculin reactivity was correlated with IFN-γ responsiveness in vitro. These results support the further study of the blood culture–IFN-γ EIA system as an alternative to skin testing for the detection of human TB infection.

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