Differences in tuberculin reactivity as determined in a veterans administration employee health screening program.
Differences in tuberculin reactivity as determined in a veterans administration employee health screening program.
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退伍军人管理局员工健康筛查计划确定的结核菌素反应性差异。
DOI：
10.1128/cvi.00375-08
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Smith,DaveyM
中科院分区：
文献类型：
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作者：
Mehta,SanjayR;MacGruder,Cathy;Looney,David;Johns,Scott;Smith,DaveyM
为了应对价格上的差异，圣地亚哥退伍军人管理医疗中心在2006年秋季将结核菌素制剂从结核菌素（Tubersol）改为阿普利索（applisol）。更改后，注意到员工皮肤测试转换的数量增加。使用QuantiFERON Gold (QFT-G) γ干扰素释放法筛选2006年员工结核菌素皮肤试验转换器。那些QFT-G测试呈阴性的员工被要求用结核菌素和阿普利索结核素制剂重复他们的皮肤测试。在新纯化的蛋白质衍生物转换器中，14个中有12个返回用QFT-G重复检测，检测结果为83%（10/12）为阴性，8%（1/12）为阳性，8%（1/12）为不确定。QFT-G阴性的9人同意重复两种结核菌素制剂的皮肤试验，7/8（87.5%）对阿普利索制剂表现出反应性，0/8（0%）对结核菌素制剂表现出反应性。从结核菌素到阿普利索尔的变化导致结核菌素皮肤试验转换率升高，这可能是由于假阳性反应。不同制剂在皮试反应性上的差异支持了CDC指南的建议，即机构不应改变结核菌素制剂，因为这样做可能会错误地增加阳性反应的数量。
In response to a difference in pricing, the San Diego Veterans Administration Medical Center changed its tuberculin preparation from Tubersol to Aplisol in the fall of 2006. Following the change, an increased number of employee skin test conversions was noted. Employee tuberculin skin test converters from 2006 were screened with the QuantiFERON Gold (QFT-G) gamma interferon release assay. Those employees who tested negative by QFT-G were asked to repeat their skin test with both Tubersol and Aplisol tuberculin preparations. Of the new purified protein derivative converters, 12 of 14 returned for repeat testing with QFT-G, and the assay was negative for 83% (10/12), positive for 8% (1/12), and indeterminate for 8% (1/12) of the individuals. Nine of the individuals who were QFT-G negative agreed to repeat skin testing with both tuberculin preparations, and 7/8 (87.5%) demonstrated reactivity with the Aplisol preparation, while 0/8 (0%) reacted to the Tubersol preparation. A change from Tubersol to Aplisol resulted in elevated tuberculin skin test conversion rates that may be due to false-positive reactions. The differences in skin test reactivity between preparations support CDC guidelines that recommend that institutions should not change tuberculin preparations, as doing so may falsely increase the number of positive reactions.