Background The health-care workers （HCWs） are at high risk of acquiring infection with Mycobacterium tuberculosis. The objectives of this study were to compare the performance of the T-SPOT.TB and tuberculin skin te...Background The health-care workers （HCWs） are at high risk of acquiring infection with Mycobacterium tuberculosis. The objectives of this study were to compare the performance of the T-SPOT.TB and tuberculin skin test （TST） for latent tuberculosis infection （LTBI）, evaluate diagnostic concordance and risk factors for LTBI, and observe the progression to active tuberculosis （TB） disease among HCWs in a general hospital in Beijing. Methods The prospective cohort study enrolled HCWs in a tertiary general hospital in Beijing, China, to evaluate LTBI with T-SPOT.TB and TST. The subjects were evaluated every 12 months during the 60-month follow-up. Results Of 101 participating HCWs, 96 and 101 had valid TST and T-SPOT.TB results, respectively. Twenty-nine （28.7%, 95% confidence interval （C/）, 19.9%-37.5%） were defined as positive by T-SPOT.TB and 53 （55.2%, 95% CI, 45.2%-64.9%） were defined as positive by TST （using a ≥10 mm cutoff）. An agreement between the two tests was poor （57.3%, K=0.18, 95% CI, 0.01%-0.52%）. In multJvariate analysis, direct exposure to sputum smear-positive TB patients was a significant risk factor for a positive T-SPOT.TB （OR 5.76; 95% CI 1.38-24.00）. Pooled frequency of antigen- specific IFN-y secreting T-cells for subjects who reported direct contact with sputum smear-positive TB patients was significantly higher than that for participants without direct contact （P=0.045）. One of 20 participants with positive result of T-SPOT.TB and TST developed active TB at 24-month follow-up.Conclusion T-SPOT.TB is a more accurate, targeted method of diagnosing LTBI than TST.展开更多
文摘Background The health-care workers （HCWs） are at high risk of acquiring infection with Mycobacterium tuberculosis. The objectives of this study were to compare the performance of the T-SPOT.TB and tuberculin skin test （TST） for latent tuberculosis infection （LTBI）, evaluate diagnostic concordance and risk factors for LTBI, and observe the progression to active tuberculosis （TB） disease among HCWs in a general hospital in Beijing. Methods The prospective cohort study enrolled HCWs in a tertiary general hospital in Beijing, China, to evaluate LTBI with T-SPOT.TB and TST. The subjects were evaluated every 12 months during the 60-month follow-up. Results Of 101 participating HCWs, 96 and 101 had valid TST and T-SPOT.TB results, respectively. Twenty-nine （28.7%, 95% confidence interval （C/）, 19.9%-37.5%） were defined as positive by T-SPOT.TB and 53 （55.2%, 95% CI, 45.2%-64.9%） were defined as positive by TST （using a ≥10 mm cutoff）. An agreement between the two tests was poor （57.3%, K=0.18, 95% CI, 0.01%-0.52%）. In multJvariate analysis, direct exposure to sputum smear-positive TB patients was a significant risk factor for a positive T-SPOT.TB （OR 5.76; 95% CI 1.38-24.00）. Pooled frequency of antigen- specific IFN-y secreting T-cells for subjects who reported direct contact with sputum smear-positive TB patients was significantly higher than that for participants without direct contact （P=0.045）. One of 20 participants with positive result of T-SPOT.TB and TST developed active TB at 24-month follow-up.Conclusion T-SPOT.TB is a more accurate, targeted method of diagnosing LTBI than TST.
