Performance of Commercial Blood Tests for the Diagnosis of Latent Tuberculosis Infection in Children and Adolescents
Performance of Commercial Blood Tests for the Diagnosis of Latent Tuberculosis Infection in Children and Adolescents
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DOI：
10.1542/peds.2008-1722
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发表时间：
2009-03-01
期刊：
影响因子：
8
通讯作者：
Richeldi, Luca
中科院分区：
文献类型：
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作者：
Bergamini, Barbara Maria;Losi, Monica;Richeldi, Luca
背景准确诊断潜伏性结核感染可降低进展为严重播散性疾病的风险。然而，在幼儿中，标准结核菌素皮肤试验的一个主要局限性是不能检测到假阴性结果。新的干扰素-γ释放测定QuantiFERON-TB Gold（Cellestis Carnegie维多利亚，澳大利亚）、QuantiFERON-TB In-Tube（Cellestis）和T-SPOT。TB（Oxford Immunotec，阿宾登，英国）显示出更高的准确度，但它们也可能受到受损细胞免疫的影响，导致不确定的结果（即，阳性对照威尔斯孔中的响应不足）。评价年龄对干扰素-γ释放试验在常规医院环境中用于疑似活动性或潜伏性结核感染儿童的影响。我们回顾性研究了496名0至19岁的儿童，他们接受了结核菌素皮肤试验和至少一种干扰素-γ释放试验：181名使用QuantiFERON-TB Gold，315名使用QuantiFERON-TB In-Tube。在154名儿童中，可进行成对干扰素-γ释放试验检测：87名使用QuantiFERON-TB Gold/T-SPOT.TB，67名使用QuantiFERON-TB In-Tube/T-SPOT. TB. MTS。与T-SPOT相比。TB，QuantiFERON-TB Gold和QuantiFERON-TB In-Tube的不确定结果率显著更高。QuantiFERON-TB Gold和QuantiFERON-TB In-Tube在≥ 4岁的儿童中也更常见不确定结果。QuantiFERON-TB Gold和QuantiFERON-TB In-Tube的不确定结果均与较年轻相关，但T-SPOT的不确定结果与较年轻相关。TB.将年龄视为二元变量（
BACKGROUND. The accurate diagnosis of latent tuberculosis infection reduces the risk of progression to severe disseminated disease. However, in young children, a major limitation of the standard tuberculin skin test is that false-negative results cannot be detected. The new interferon-gamma release assays QuantiFERON-TB Gold (Cellestis Carnegie Victoria, Australia), QuantiFERON-TB In-Tube ( Cellestis), and T-SPOT. TB ( Oxford Immunotec, Abingdon, United Kingdom) show promise of greater accuracy, but they may also be affected by impaired cellular immunity, resulting in indeterminate results (ie, insufficient response in positive-control wells).OBJECTIVE. To evaluate the impact of age on the performance of interferon-gamma release assays when used in a routine hospital setting among children tested for suspected active or latent TB infection.METHODS. We retrospectively studied 496 children 0 to 19 years of age who had been tested with the tuberculin skin test and at least 1 interferon-gamma release assay: 181 with QuantiFERON-TB Gold and 315 with QuantiFERON-TB In-Tube. In 154 of the children, paired interferon-gamma release assay testing was available: 87 with QuantiFERON-TB Gold/T-SPOT.TB and 67 with QuantiFERON-TB In-Tube/T-SPOT.TB.RESULTS. Compared with T-SPOT. TB, the rates of indeterminate results were significantly higher for both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube. QuantiFERON-TB Gold and QuantiFERON-TB In-Tube also gave indeterminate results more frequently in children = 4 years of age. Indeterminate results were associated with younger age for both QuantiFERON-TB Gold and QuantiFERON-TB In-Tube but not for T-SPOT. TB. Considering age as a binary variable (