Tuberculin test conversion during repeated skin testing, associated with sensitivity to nontuberculous mycobacteria.
Tuberculin test conversion during repeated skin testing, associated with sensitivity to nontuberculous mycobacteria.
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重复皮肤测试期间的结核菌素测试转换，与对非结核分枝杆菌的敏感性相关。
DOI：
10.1164/arrd.1979.120.1.59
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发表时间：
1979
期刊：
影响因子：
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通讯作者：
J. Heidenreich
中科院分区：
文献类型：
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作者：
N. M. Richards;K. Nelson;M. Batt;D. Hackbarth;J. Heidenreich
为了确定短时间间隔后重复结核菌素试验是否会导致结核菌素转化，我们对213名健康志愿者进行了两次试验，间隔1个月，使用5tu结核菌素纯化蛋白衍生物（PPD）。三种非结核分枝杆菌抗原（PPD-G， PPD-Y和PPD-B）也应用于第一次结核菌素试验。根据广泛使用的标准，14名志愿者（6.6%）在第二次检测中将结核菌素检测结果从阴性转为阳性。103名非结核性抗原敏感的受试者中有13名（12.6%）将结核菌素试验转化为阳性，而110名没有已知既往分枝杆菌敏感性的受试者中只有1名（0.9%）转化为阳性（P < 0.005; x2 = 10.05）。在第二次测试后6.5个月再次测试5tu结核菌素PPD时，13个转换者中有9个恢复为阴性。我们得出结论，结核菌素转换可能发生在1个月后重复皮肤试验时，交叉反应分枝杆菌敏感性的增强可能导致部分转换发生在年轻、健康的中西部志愿者人群中。结核菌素试验也可提高对结核分枝杆菌的敏感性。由于结核和非结核分枝杆菌致敏的流行率在不同的人群中可能有所不同，因此结核菌素转化的重要性也会因被测试人群而异。
To determine whether repeating the tuberculin test after a brief interval might result in tuberculin conversion, we tested 213 healthy volunteers twice, 1 month apart, with 5 TU of tuberculin purified protein derivative (PPD). Three nontuberculous mycobacterial antigens (PPD-G, PPD-Y, and PPD-B) were also applied with the first tuberculin test. By widely used criteria, 14 volunteers (6.6 per cent) converted their tuberculin tests from negative to positive on the second testing. Whereas 13 of 103 subjects (12.6 per cent) with nontuberculous antigen sensitivity converted their tuberculin test to positive, only one of 110 subjects (0.9 per cent) with no known prior mycobacterial sensitivity converted to positive (P less than 0.005; x2 = 10.05). When retested with 5 TU of tuberculin PPD 6.5 months after the second test, nine of 13 converters reverted to negative. We conclude that tuberculin conversion may occur when the skin test is repeated at 1 month, and that boosting of cross-reacting mycobacterial sensitivity might have caused a portion of the conversions in this population of young, healthy midwestern volunteers. Sensitivity to Mycobacterium tuberculosis might also be boosted by tuberculin testing. Because the prevalence of sensitization by tuberculous and nontuberculous mycobacteria can be expected to vary in different populations, the significance of tuberculin conversion will also vary with the population being tested.