Evaluation of the clinical usefulness of mycobacterial skin test antigens in adults with pulmonary mycobacterioses

Am Rev Respir Dis. 1992 May;145(5):1160-6. doi: 10.1164/ajrccm/145.5.1160.


A double-blind, multicenter study was conducted to evaluate the usefulness of mycobacterial skin test antigens for the specific diagnosis of adult pulmonary mycobacterial disease. The skin test antigens used were PPD-T (M. bovis) and PPD-B (M. intracellulare), made bioequivalent to 5 TU PPD-S through bioassay in human subjects. Of the 192 adults (18 yr of age or older), those with disease caused by M. tuberculosis (MTB) had significantly larger reactions to PPD-T than did those with disease caused by nontuberculous mycobacteria (NTM) or those with negative culture results (NEG)(13.41 mm versus 4.87 and 4.96 mm, respectively, p less than 0.001). The mean induration to PPD-B in NTM was not different from that in MTB or NEG. Defining a "positive" to be greater than or equal to 10 mm induration and a size difference of greater than or equal to 3 mm between PPD-T and PPD-B, the sensitivity, specificity, and positive predictive value (PPV) for PPD-T in diagnosing MTB versus NTM was 29, 90, and 75%. Corresponding values for PPD-B and NTM disease were 70, 61, and 64%. Dual testing was less useful in distinguishing disease caused by any of the mycobacteria from NEG. Although the sensitivity of PPD-B, made bioequivalent to PPD-S, was high, the specificity and PPV were low. We conclude that this preparation of PPD-B is no more useful in distinguishing adult pulmonary disease caused by NTM than is PPD-T alone.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial
  • Multicenter Study

MeSH terms

  • Double-Blind Method
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Mycobacterium avium Complex / immunology
  • Mycobacterium avium-intracellulare Infection / diagnosis*
  • Mycobacterium bovis / immunology
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Tuberculin / immunology*
  • Tuberculin Test*
  • Tuberculosis, Pulmonary / diagnosis*


  • Tuberculin