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- Title
Comparable specificity of 2 commercial tuberculin reagents in persons at low risk for tuberculous infection.
- Authors
Villarino, Margarita E.; Burman, William; Wang, Yong-Chen; Lundergan, Linda; Cantanzaro, Antonino; Bock, Naomi; Jones, Crystal; Nolan, Charles; Villarino, M E; Burman, W; Wang, Y C; Lundergan, L; Catanzaro, A; Bock, N; Jones, C; Nolan, C
- Abstract
<bold>Context: </bold>One or both commercial tuberculin skin test reagents (Aplisol and Tubersol) may have a high rate of false-positive reactions.<bold>Objective: </bold>To compare the reaction size and specificity of skin testing with Aplisol, Tubersol, and the standard purified protein derivative (PPD-S1).<bold>Design: </bold>Double-blind trial, conducted between May 14, 1997, and October28, 1997, in which each individual received 4 tuberculin skin reagents at sites assigned at random.<bold>Setting: </bold>Health departments and universities in 6 US cities.<bold>Participants: </bold>A total of 1555 persons at low risk of latent tuberculosis infection.<bold>Intervention: </bold>Simultaneous skin tests with Aplisol, Tubersol, PPD-S1, and either a second PPD-S1 or PPD-S2 (a proposed new standard).<bold>Main Outcome Measure: </bold>Reaction size at each injection site measured by 2 investigators blinded to type of reagent.<bold>Results: </bold>Aplisol produced slightly larger reactions than Tubersol, but this difference did not significantly change skin test interpretation. The mean +/- SD reaction sizes were 3.4+/-4.2 mm with Aplisol, 2.1+/-3.2 mm with Tubersol, and 2.5+/-3.6 mm with PPD-S1. Assuming that all participants were uninfected and using a 10-mm cutoff, the specificities of the tests were high: Aplisol, 98.2%; Tubersol, 99.2%; and PPD-S1, 98.9%. Significant variability was not detected in interobserver, host, and lot-to-lot reagent comparisons.<bold>Conclusion: </bold>Using a cutoff of at least 10 mm, testing with 3 different PPD reagents resulted in similar numbers of uninfected persons being correctly classified.
- Subjects
TUBERCULIN test; TUBERCULOSIS diagnosis; SKIN tests; PROVOCATION tests (Medicine)
- Publication
JAMA: Journal of the American Medical Association, 1999, Vol 281, Issue 2, p169
- ISSN
0098-7484
- Publication type
journal article
- DOI
10.1001/jama.281.2.169