Poor correlation between tuberculin skin tests and interferon-γ assays in close contacts of patients with multidrug-resistant tuberculosis

Respirology. 2012 Oct;17(7):1125-30. doi: 10.1111/j.1440-1843.2012.02218.x.

Abstract

Background and objective: The results of tuberculin skin tests (TST) and QuantiFERON TB-Gold In-Tube (QFT-GIT) assays were compared in close contacts of patients with multidrug-resistant tuberculosis (MDR-TB).

Methods: Close contacts of patients with bacteriologically confirmed MDR-TB (n = 101) were assessed. Most contacts were members of the households of patients, and 79 (78.2%) had received Bacille Calmette-Guerin (BCG) vaccination. Samples from each contact were tested using the TST and the QFT-GIT assay on the same day, and the concordance between these results was assessed using kappa (κ) coefficients.

Results: Forty-eight subjects (47.5%) showed positive responses on TST, using a 10-mm induration cut-off, and 54 (53.5%) were positive for the QFT-GIT assay. Of the 48 individuals who were TST positive, 34 (70.8%) were positive for the QFT-GIT assay. Of the 53 subjects who were TST negative, 33 (62.5%) were negative for the QFT-GIT assay. The overall agreement between the two tests (κ coefficient) was 0.33. The κ coefficient was higher in the 22 subjects who had not received BCG vaccination (κ = 0.48) than in the 79 subjects who had received BCG vaccination (κ = 0.29).

Conclusion: The TST and QFT-GIT assays showed poor correlation in close contacts of patients with MDR-TB, especially those contacts who had received BCG vaccination.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Humans
  • Interferon-gamma / blood*
  • Interferon-gamma Release Tests*
  • Male
  • Middle Aged
  • Prospective Studies
  • Tuberculin Test / methods*
  • Tuberculosis, Multidrug-Resistant / diagnosis*
  • Young Adult

Substances

  • Interferon-gamma