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Conversion rates of an interferon-γ release assay and the tuberculin skin test in the serial monitoring of healthcare workers

 S. Y. Kim  ;  M. S. Park  ;  Y. S. Kim  ;  S. K. Kim  ;  J. Chang  ;  Y. A. Kang 
 INFECTION, Vol.41(2) : 511-516, 2013 
Journal Title
Issue Date
Adult ; Enzyme-Linked Immunosorbent Assay ; Epidemiological Monitoring ; Female ; Follow-Up Studies ; Health Personnel ; Humans ; Interferon-gamma Release Tests/methods* ; Latent Tuberculosis/diagnosis* ; Male ; Middle Aged ; Occupational Diseases/diagnosis* ; Occupational Diseases/microbiology ; Occupational Exposure/analysis ; Prospective Studies ; Reproducibility of Results ; Republic of Korea ; Risk Factors ; Time Factors ; Tuberculin Test/methods* ; Young Adult
Healthcare workers ; Latent tuberculosis ; Interferon-γ release assay ; Tuberculin skin test ; Serial testing
PURPOSE: Regular monitoring of latent tuberculosis (TB) infection in healthcare workers (HCWs) is recommended, but the view about the effective method and performance of serial monitoring is controversial. The aim of this study was to determine differences in conversion rates according to TB exposure risk using the tuberculin skin test (TST) and the QuantiFERON-TB Gold In-Tube (QFT-GIT), and to evaluate the reproducibility and within-subject variability of the QFT-GIT in South Korea. METHODS: Fifty-three HCWs were grouped according to their risk for TB exposure: group 1, high risk (n = 21); group 2, low risk (n = 32). Baseline and follow-up TSTs and QFT-GITs were performed from June 2009 to July 2011. Enzyme-linked immunosorbent assays (ELISAs) were repeated for the second QFT-GIT and a third QFT-GIT was performed after 8 weeks when discordant results of the second TST and QFT-GIT or a conversion or reversion were observed. RESULTS: No difference in the QFT-GIT conversion rate was evident between the two groups (15.4 vs. 6.5 %, p = 0.57), and no TST conversion was observed. The rate of QFT-GIT positivity was higher in the high-risk group (first QFT-GIT: 38.1 vs. 3.1 %, p = 0.002; second QFT-GIT: 33.3 vs. 9.4 %, p = 0.039). The re-test reproducibility of QFT-GIT results was high (100 %), and the within-subject results of repetitive QFT-GITs were variable. CONCLUSIONS: Stricter prevention strategies remain necessary in HCWs at high risk of TB exposure, and serial interferon-γ release assays (IGRAs) should be interpreted with caution in HCWs.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Se Kyu(김세규)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
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