Comparison and analysis of TST and IGRAs for testing tuberculosis infection of health care workers

doi:10.3969/j.issn.1000-6621.2014.02.008

Abstract

Abstract: Objective To compare and analyze the agreement of tuberculosis (TB) infection results of health care workers with tuberculin skin test (TST) and interferon γ release assays (IGRAs). Methods Between April to August 2010, 1005 health care workers in an infectious disease hospital and a general medical hospital in Inner Mongolia were enrolled. Questionnaire was used to get the general demographic information, the history of BCG vaccination and so on. 1005 questionnaires were sent out, and 952 qualified questionnaires were taken back (the number of medical staff completed questionnaires, received TST and QFT - GIT test was 952, 924 and 999 respectively),923 subjects completes all of the three inquiries, excluding 6 with not-sure QFT-GIT results, there were 917 health care workers in the analysis. We applied TST and one of IGRAs namely QuantiFERON-TB Gold In-Tube (QFT-GIT) assay to test tuberculosis infection of health care workers, and assessed the agreement of the two tests with Kappa coefficients with the 5 mm, 10 mm and 15 mm as the positive cut-off of TST. Results Of the 917 health care wor-kers included in the analysis, the TST positive rates were 68.92% (632/917), 47.87% (439/917) and 25.08% (230/917) respectively with the different positive cut-off of 5 mm, 10 mm and 15 mm. With 5 mm as the positive cut-off, there were 483 medical staff got positive results and 130 got negative results of the two tests, and the agreement rate was 66.85% (613/917). With 10 mm as the positive cut-off, there were 350 medical staff got positive results and 190 got negative results of the two tests, and the agreement rate was 58.89% (540/917). With 15 mm as the positive cut-off, there were 181 medical staff got positive results and 230 got negative results of the two tests, and the agreement rate was 44.82% (411/917).The Kappa value (95%CI) between the tests were 0.22 (0.16-0.29), 0.19(0.13-0.25) and 0.08 (0.04-0.12) respectively, the agreement was poor. Conclusion The agreement between TST and QFT-GIT was low.

Key words: Tuberculin test, Interferon-gamma release tests, Mycobacterium tuberculosis, Disease transmission, professional-to-patient

GENG Meng-jie, SONG Yu-dan, XIONG Yong-chao, ZHAO Fei, HU Dong-mei, LI Meng, HOU Yue-yun, CHENG Jun, HE Guang-xue. Comparison and analysis of TST and IGRAs for testing tuberculosis infection of health care workers[J]. Chinese Journal of Antituberculosis, 2014, 36(2): 121-125. doi: 10.3969/j.issn.1000-6621.2014.02.008

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