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- Title
Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis.
- Authors
Carvalho, A.; Schumacher, R.; Bigoni, S.; Soncini, E.; Notarangelo, L.; Apostoli, A.; Bonfanti, C.; Cirillo, D.; Mantegani, P.; Porta, F.; Comelli, M.; Matteelli, A.
- Abstract
Background: Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. Methods: Children who were exposed to a contagious TB case underwent serial QuantiFERON TB Gold In-Tube (QFT-GIT) and T-SPOT.TB (T-SPOT) testing. Results: Eighteen children were tested. At the first testing, only two children (11 %) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 %) than with T-SPOT (12 %). In the multivariable analysis, a statistically significant association of lymphocyte count <500 cells/mm ( p < 0.00005) and low age ( p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT ( p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. Conclusion: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficient children. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.
- Subjects
TUBERCULOSIS transmission; DIFFERENTIAL diagnosis; CLINICAL pathology; HEMATOLOGY; HOSPITAL wards; CASE studies; ONCOLOGY; QUESTIONNAIRES; STATISTICAL hypothesis testing; WORLD Wide Web; INTERFERON gamma release tests; CHILDREN
- Publication
Infection, 2013, Vol 41, Issue 4, p827
- ISSN
0300-8126
- Publication type
Report
- DOI
10.1007/s15010-013-0450-y