Questionable effectiveness of the QuantiFERON-TB Gold Test (Cellestis) as a screening tool in healthcare workers

Infect Control Hosp Epidemiol. 2010 Dec;31(12):1279-85. doi: 10.1086/657336. Epub 2010 Oct 27.


Objective: The Center for Disease Control and Prevention recommends the use of QuantiFERON TB Gold test (QFTG; Cellestis) in all situations where the tuberculin skin test (TST) is used. In November 2007, our institution replaced its screening-tool TST with the QFTG in-tube assay (QFT-GIT) for annual screening of latent tuberculosis infection among healthcare workers (HCWs). This study evaluated the effectiveness of QFT-GIT test as screening tool in HCWs at our institution.

Methods: This retrospective study reviewed medical records of all HCWs who underwent screening with QFT-GIT from January 2008 through December 2008.

Results: Among the 6,530 HCWs screened with QFT-GIT from January through December 2008, 287 had a positive test result. Of the 287, 123 had positive TST results in the past, meaning that 164 HCWs had newly diagnosed latent tuberculosis infection by QFT-GIT. Of the 164 HCWs, 135 were retested by QFT-GIT and were simultaneously tested with TST within 4 weeks after the initial QFT-GIT. Of these 135 HCWs, 66 reverted to negative results and results remained positive for 69 with QFT-GIT. Only 2 HCWs had a positive TST result.

Conclusions: The disagreement between QFT-GIT and TST results and the high reversion rate with QFT-GIT raise concerns about the effectiveness of QFT-GIT as a sole screening test in HCWs.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Centers for Disease Control and Prevention, U.S.
  • Enzyme-Linked Immunosorbent Assay / economics
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Enzyme-Linked Immunosorbent Assay / standards*
  • Female
  • Health Personnel*
  • Hematologic Tests / economics
  • Hematologic Tests / methods
  • Hematologic Tests / standards
  • Humans
  • Illinois
  • Interferon-gamma / immunology
  • Latent Tuberculosis / blood
  • Latent Tuberculosis / diagnosis*
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / immunology*
  • Mycobacterium tuberculosis / isolation & purification
  • Occupational Diseases / diagnosis
  • Occupational Diseases / economics
  • Population Surveillance / methods*
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tuberculin Test
  • United States


  • Interferon-gamma