A PSEUDOEPIDEMIC OF TUBERCULIN SKIN TEST CONVERSIONS CAUSED BY A PARTICULAR LOT OF PURIFIED PROTEIN DERIVATIVE OF TUBERCULIN TEST SOLUTION

1995 ◽  
Vol 14 (5) ◽  
pp. 392 ◽  
Author(s):  
Theodore J. Cieslak ◽  
Robert G. Irwin ◽  
Patricia A. Dougherty ◽  
Gea M. Miller
PEDIATRICS ◽  
1996 ◽  
Vol 98 (1) ◽  
pp. 161-161
Author(s):  
Alberto Bertotto ◽  
Fabrizio Spinozzi ◽  
Maurizio Radicioni ◽  
Renato Vaccaro

Localized erythema at the site of a previous bacillus Calmette-Guérin (BCG) inoculation is a relatively specific and early manifestation of Kawasaki disease (KD),1 and redness and crusting are characteristic features at the site of BCG immunization during the acute phase of the illness.2 With these findings in mind, we evaluated the tuberculin skin test reactivity of children with KD, as determined by a commercially available (Sclavo, Siena, Italy) and intradermally injected (5 TU) purified protein derivative (PPD).


2000 ◽  
Vol 68 (12) ◽  
pp. 7094-7099 ◽  
Author(s):  
Mark A. Chambers ◽  
Ann Williams ◽  
Dolores Gavier-Widén ◽  
Adam Whelan ◽  
Graham Hall ◽  
...  

ABSTRACT Tuberculosis remains one of the most significant diseases of humans and animals. The only currently available vaccine against this disease is a live, attenuated vaccine, bacillus Calmette-Guérin (BCG), which was originally derived from Mycobacterium bovis and despite its variable efficacy is the most widely administered vaccine in the world. With the advent of the human immunodeficiency virus-AIDS pandemic concern has been raised over the safety of BCG. Moreover, since BCG sensitizes vaccinated individuals to the tuberculin test, vaccination with BCG prevents diagnosis of infection in vaccinated individuals. Recently, auxotrophic strains of BCG have been generated by insertional mutagenesis which have been shown to be safer than the parent BCG strain following administration to mice with severe combined immunodeficiency disease. These strains have also been shown to give comparable protection against intravenous and intratracheal challenge of BALB/c mice with M. tuberculosis relative to conventional BCG. Here we report that one of these mutants, a leucine auxotroph of BCG, conferred significant protection of the lungs and spleens of guinea pigs infected with M. bovis and protection of the spleens of guinea pigs infected with M. tuberculosis in the absence of a cutaneous hypersensitivity reaction to tuberculin. Therefore, protective immunity to tuberculosis may, at least in part, be achieved without sensitization to the tuberculin skin test. These results indicate that it may be possible to develop a new generation of vaccines based on BCG that are protective, are safe for use in the immunocompromised, and do not preclude the use of the tuberculin skin test in both humans and animals.


2020 ◽  
Vol 15 ◽  
Author(s):  
Zia Abdullah ◽  
Arvind Kumar ◽  
M. A. Khan ◽  
Uma Kumar ◽  
Surabhi Vyas ◽  
...  

Objective:: The study was conducted to determine whether synthetic disease modifying Anti Rheumatic drugs (DMARDs) suppresses the latency of Tuberculosis (TB) infection in Rheumatoid Arthritis (RA) patients along with other variables. Methods:: This was done through Tuberculin Skin Test (TST) using Purified protein derivative (PPD) in cohort of RA Patients. The TST was taken positive when induration post PPD injection was  5mm and negative or anergic when it was < 5mm. We included 100 patients (N = 100). Results:: The prevalence of positive TST was 36%, while 64% presented a negative result. Negative TST was significantly associated with steroid usage (39.4%, 95% CI: 28.4%-51.4%). Anergic (TST negative) and non-anergic (TST positive) patients were separated in groups, and a new analysis was done with elaboration on DMARDs used. Conclusion:: Steroid use and not treatment with methotrexate or other DMARDs was associated with TST negativity and thus TST should be interpreted with caution especially before starting biologicals.


2014 ◽  
Vol 21 (9) ◽  
pp. 1309-1313 ◽  
Author(s):  
Susan L. Baldwin ◽  
Valerie Reese ◽  
Brian Granger ◽  
Mark T. Orr ◽  
Gregory C. Ireton ◽  
...  

ABSTRACTThe tuberculin skin test (TST) is a simple and inexpensive test to determine whether individuals have been exposed toMycobacterium tuberculosis. This test is not always reliable, however, in people previously immunized with BCG and/or who have been exposed to environmental mycobacterial species due to a reaction to purified protein derivative (PPD) used in the skin test. An issue with BCG, therefore, is that the resulting sensitization to PPD in some individuals compromises the diagnostic use of the skin test. The ability to induce protective immune responses without sensitizing to the tuberculin skin test will be important properties of next-generation tuberculosis (TB) vaccine candidates. We show here that guinea pigs immunized with the candidate TB vaccine ID93/GLA-SE, currently in clinical trials, do not react to intradermal PPD administration. In contrast, positive DTH responses to both ID93 and components thereof were induced in ID93/GLA-SE-immunized animals, indicating robust but specific cellular responses were present in the immunized animals. Noninterference with the TST is an important factor for consideration in the development of a vaccine againstM. tuberculosis.


2004 ◽  
Vol 11 (5) ◽  
pp. 952-956 ◽  
Author(s):  
M. Cagiola ◽  
F. Feliziani ◽  
G. Severi ◽  
P. Pasquali ◽  
D. Rutili

ABSTRACT Bovine tuberculosis (TB) is still a zoonotic problem in the world. Despite the fact that eradication programs for bovine TB are being implemented in many countries, it remains a public health problem. These programs are mainly based on a single intradermal tuberculin test using bovine tuberculin purified protein derivative (PPD), isolation, and slaughtering of infected animals. The aim of this study was to assess the specificity of the gamma interferon (IFN-γ) test in TB-free cattle herds, by using not only Australian tuberculins but also tuberculins produced at our institute, and to correlate the response with the type of production (beef cattle, dairy cattle, and a dual-purpose breed), the housing system, and the age of the animals. We studied 800 animals selected from 20 TB- and paratuberculosis-free herds. The animals were tested in parallel, after stimulation with Australian tuberculins and tuberculins produced at our institute, by using the skin test and two IFN-γ assays. The results of this trial showed that the specificity of the IFN-γ test is higher than that of the skin test (96.8%) and ranges from 97.3% (using only Australian tuberculins) to 98.6% (using tuberculins produced at our institute). We found that different categories of cattle could influence the specificity of the skin test but that these differences tended to be reduced in the IFN-γ assay, especially when Italian PPDs were used.


2012 ◽  
Vol 7 (1) ◽  
pp. 28-35
Author(s):  
PK Jha ◽  
R Gurung ◽  
N Gyawali ◽  
HP Nepal ◽  
DD Baral ◽  
...  

The study was carried out to assess the value of tuberculin skin test for the diagnosis of Tuberculosis (TB) in BCG vaccinated individuals and to find out the sensitivity rate of tuberculin skin test (TST) in comparison to acid fast bacilli positive pulmonary TB. Similar population with high BCG vaccination coverage having both pulmonary TB patients (n=150) and apparently healthy individuals (n=150) in eastern Nepal were enrolled in this comparative study. Sputum from all the subjects was subjected to Z-N microscopy. TST was performed on these subjects by standard Mantoux method. Among the patients (mean age 36.18±14.15 yrs) and controls (mean age 35.61±13.44 yrs), 55.33 % and 47.33 % respectively have been found to be positive PPD reactors (>10mm) which is statistically not significant (P>0.05). About 23% of the patients & 27% of controls failed to react (anergic) to 5 TU PPD. PPD reactivity rate was high in the patients whose sputum smears were graded as 1+ in Z-N microscopy. The sensitivity of TST was highest for the induration of >5mm (77.3%). Specificity increased with increasing size of induration and was highest (73.3%) with induration of >15 mm. Tuberculin skin test is an all or none phenomenon. In Nepal, tuberculin test has a limited value in the diagnosis of pulmonary TB as both the apparently healthy individuals and patients with sputum smear positive pulmonary TB who had been immunized with BCG, showed almost similar rate of tuberculin reactivity. DOI: http://dx.doi.org/10.3126/jcmsn.v7i1.5970 JCMSN 2011; 7(1): 28-35


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