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- Title
Risk factors for false-negative results of T-SPOT.<i>TB</i> and tuberculin skin test in extrapulmonary tuberculosis.
- Authors
Lee, Y.-M.; Park, K.-H.; Kim, S.-M.; Park, S. J.; Lee, S.-O.; Choi, S.-H.; Kim, Y. S.; Woo, J. H.; Kim, S.-H.
- Abstract
Purpose: T-SPOT. TB, a recently developed T cell-based assay, has shown promise in diagnosing extrapulmonary tuberculosis (EPTB). However, a limited number of reports have compared the risk factors for false-negative results of tuberculin skin tests (TSTs) and T-SPOT. TB assays in patients with EPTB. We, thus, conducted a prospective, blinded, observational study to evaluate the risk factors for false-negative T-SPOT. TB and TST results in patients with EPTB. Methods: Between April 2008 and November 2011, all adult patients with suspected EPTB were prospectively enrolled at Asan Medical Center, Seoul, South Korea (an intermediate TB-burden country). Only patients with confirmed and probable EPTB who underwent TST and T-SPOT. TB were included in the final analysis. Results: Of the 324 patients who underwent both TST and T-SPOT. TB testing, 128 patients with 96 (75 %) culture- or polymerase chain reaction (PCR)-confirmed and 32 (25 %) probable EPTB were finally analyzed. T-SPOT. TB assays were less likely to yield false-negative results than TSTs [17 % (22/128) vs. 54 % (69/128), p < 0.001]. In a multivariate analysis, miliary TB was associated with false-negative TSTs [odds ratio (OR) = 5.3; 95 % confidence interval (CI) 1.7–16.1], while immunosuppression showed a trend toward false-negative TSTs (OR = 2.5; 95 % CI 0.9–6.8). Conversely, lymph node TB (OR = 0.2; 95 % CI 0.1–0.5) and skeletal TB (OR = 0.2; 95 % CI 0.1–0.5) were associated with true-positive TST results. The only risk factor for false-negative T-SPOT. TB results was TB meningitis (OR = 2.6; 95 % CI 1.0–6.6). Conclusions: Our findings suggest that T-SPOT. TB has a better sensitivity to diagnose EPTB than TST, especially in patients with immunosuppression or miliary TB.
- Subjects
SOUTH Korea; ACADEMIC medical centers; CONFIDENCE intervals; STATISTICAL correlation; DIAGNOSTIC errors; MULTIVARIATE analysis; RESEARCH funding; RISK assessment; T-test (Statistics); TUBERCULIN test; U-statistics; LOGISTIC regression analysis; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio
- Publication
Infection, 2013, Vol 41, Issue 6, p1089
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-013-0478-z