A prospective longitudinal study evaluating a T-cell-based assay for latent tuberculosis infection in health-care workers in a general hospital in Beijing / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 2039-2044, 2013.
Article
Dans Anglais
| WPRIM
| ID: wpr-273041
ABSTRACT
<p><b>BACKGROUND</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>Of 101 participating HCWs, 96 and 101 had valid TST and T-SPOT.TB results, respectively. Twenty-nine (28.7%, 95% confidence interval (CI), 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%, κ = 0.18, 95%CI, 0.01% - 0.52%). In multivariate 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-γ 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.</p><p><b>CONCLUSION</b>T-SPOT.TB is a more accurate, targeted method of diagnosing LTBI than TST.</p>
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Test tuberculinique
/
Projets pilotes
/
Études prospectives
/
Facteurs de risque
/
Études longitudinales
/
Personnel de santé
/
Diagnostic
/
Allergie et immunologie
/
Tuberculose latente
/
Hôpitaux généraux
Type d'étude:
Etude diagnostique
/
Etude d'étiologie
/
Étude observationnelle
/
Facteurs de risque
Limites du sujet:
Adulte
/
Femelle
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Chinese Medical Journal
Année:
2013
Type:
Article
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