Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country ...Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.展开更多
Background：Interferon-gamma release assay （IGRA） has been used in latent tuberculosis （TB） infection and TB diagnosis,but the results from different high TB-endemic countries are different.The aim of this study w...Background：Interferon-gamma release assay （IGRA） has been used in latent tuberculosis （TB） infection and TB diagnosis,but the results from different high TB-endemic countries are different.The aim of this study was to investigate the value of IGRA in the diagnosis of active pulmonary TB （PTB） in China.Methods：We conducted a large-scale retrospective multicenter investigation to further evaluate the role of IGRA in the diagnosis of active PTB in high TB-epidemic populations and the factors affecting the performance of the assay.All patients who underwent valid T-SPOT.TB assays from December 2012 to November 2015 in six large-scale specialized TB hospitals in China and met the study criteria were retrospectively evaluated.Patients were divided into three groups：Group 1,sputum culture-positive PTB patients,confirmed by positive Mycobacterium tuberculosis sputum culture;Group 2,sputum culture-negative PTB patients;and Group 3,non-TB respiratory diseases.The medical records of all patients were collected.Chi-square tests and Fisher＇s exact test were used to compare categorical data.Multivariable logistic analyses were performed to evaluate the relationship between the results of T-SPOT in TB patients and other factors.Results：A total of 3082 patients for whom complete information was available were included in the investigation,including 905 sputum culture-positive PTB cases,914 sputum cultmre-negative PTB cases,and 1263 non-TB respiratory disease cases.The positive rate of T-SPOT.TB was 93.3% in the culture-positive PTB group and 86.1% in the culture-negative PTB group.In the non-PTB group,the positive rate of T-SPOT.TB was 43.6%.The positive rate of T-SPOT.TB in the culture-positive PTB group was significantly higher than that in the culture-negative PTB group （x2 =25.118,P 〈 0.01）,which in turn was significantly higher than that in the non-TB group （x2 =566.l 16,P 〈 0.01）.The overall results were as follows：sensitivity,89.7%;specificity,56.37%;positive predictive value,74.75%;negative predictive value,79.11%;and accuracy,76.02%.Conclusions：High false-positive rates of T-SPOT.TB assays in the non-TB group limit the usefulness as a single test to diagnose active TB in China.We highly recommend that IGRAs not be used for the diagnosis of active TB in high-burden TB settings.展开更多
Objective To compare the diagnostic performance of interferon gamma releasing assays(T-SPOT.TB)and adenosine deaminase(ADA)in pleural tuberculosis,and therefore to evaluate the value of T-SPOT.TB in a high tuberculosi...Objective To compare the diagnostic performance of interferon gamma releasing assays(T-SPOT.TB)and adenosine deaminase(ADA)in pleural tuberculosis,and therefore to evaluate the value of T-SPOT.TB in a high tuberculosis burden country.Methods From June 2011to November 2012,111 patients with pleural fluid in Beijing Chest Hospital,Capital Medical University展开更多
Background: Oman is a high-income, low prevalent country for tuberculosis disease. Although the rates have remained static over the last decade, the country is aiming for Tuberculosis (TB) elimination. Household conta...Background: Oman is a high-income, low prevalent country for tuberculosis disease. Although the rates have remained static over the last decade, the country is aiming for Tuberculosis (TB) elimination. Household contacts of pulmonary TB (PTB) patients form a high-risk group of susceptible individuals who could remain reservoirs of active disease. Objective: A retrospective study was conducted to estimate the prevalence of latent TB infection by Tuberculin Skin Test (TST) or Interferon-Gamma Release Assay (IGRA) screening tests among the household contacts of Omani patients with pulmonary tuberculosis. Design: A cross-sectional survey conducted between 2017 and 2018 of TB cases and their contacts in Muscat Governorate, Oman. Results: Out of the 278 contacts identified, 188 contacts fulfilled the inclusion criteria and were enrolled into the study. The prevalence of Latent Tuberculosis Infection (LTBI) was 22.8% (95% CI: 17.0 - 29.5) among household contacts. We found higher proportions of LTBI among females than males (28.7% vs. 15%, p = 0.027). Those who were exposed to Acid Fast Bacilli (AFB) smear positive cases were more likely to be LTBI (28.7% versus 15% in smear negative cases;p = 0.047). We also found an increasing trend of infection (32.3%) in the oldest age group (46 - 80 years). Conclusion: Besides children, female household contacts and older age contacts should be prioritized for screening as they are more likely to be infected and develop active disease.展开更多
Objective: This study aimed to determine prevalence of latent tuberculosis infection among medical students and tuberculosis exposure at the health facilities. Methods: A cross-section of study year 1(n=68) and year 5...Objective: This study aimed to determine prevalence of latent tuberculosis infection among medical students and tuberculosis exposure at the health facilities. Methods: A cross-section of study year 1(n=68) and year 5(n=75) medical students in a local university were recruited for latent tuberculosis infection testing using QuantiFERON-TB Gold Plus and a questionnaire analyzed for multivariate risk. Results: The majority of the study were vaccinated with BCG. None of year 1 medical students were positive for latent tuberculosis infection, however, six(8.0%) year 5 students were tested positive for latent tuberculosis infection. A higher incidence of year 5 medical students claimed to be exposed to tuberculosis at health facility(65.3% vs. 4.4%) and a higher percentage reported contact with tuberculosis case over the preceding year compared to year 1 students(30.7% vs. 8.8%). Conclusion: We observed a higher incidence of latent tuberculosis infection and higher exposure to tuberculosis in health facilities among year 5 medical students. Baseline screening and monitoring for progression to tuberculosis infection may benefit tuberculosis management programs.展开更多
Most people with latent Mycobacterium tuberculosis infection can partly develop active tuberculosis (TB). Therefore, diagnosis of this condition bears significance in early TB prevention. To date, the main methods for...Most people with latent Mycobacterium tuberculosis infection can partly develop active tuberculosis (TB). Therefore, diagnosis of this condition bears significance in early TB prevention. To date, the main methods for diagnosis of latent TB infection (LTBI) include tuberculin skin test and interferon γ release test. These two methods feature their own advantages and disadvantages. Although new diagnostic markers continually emerge, no uniform diagnostic criteria are available for TB detection. This study summarizes several methods for diagnosis of LTBI and new related markers and their application value in clinical practice.展开更多
结核分支杆菌复合群引起的人和动物结核病,对人类健康及畜牧业发展造成了严重的威胁,早期诊断对于结核病的防控至关重要。在结核病众多诊断方法中,免疫学诊断方法中γ干扰素释放试验具有很好的应用前景。γ干扰素释放试验刺激抗原以结...结核分支杆菌复合群引起的人和动物结核病,对人类健康及畜牧业发展造成了严重的威胁,早期诊断对于结核病的防控至关重要。在结核病众多诊断方法中,免疫学诊断方法中γ干扰素释放试验具有很好的应用前景。γ干扰素释放试验刺激抗原以结核菌素(purified protein derivative,PPD)为主,然而PPD抗原成分复杂,诊断特异性和敏感性有待提高,因此寻找可以代替PPD的特异性刺激抗原成为了研究热点。论文系统综述了近年来报道用于γ干扰素释放试验的刺激抗原,重点概述了刺激抗原的免疫特性、刺激效果以及各类刺激抗原的优势、局限性和应用前景,以期为人和动物结核病的诊断及防控提供参考。展开更多
目的探讨菌量负荷、疾病活动性、影像学累及范围、外周血淋巴细胞计数等因素对全血γ干扰素释放试验结果的影响。方法选取肺结核患者106例(包括44例菌阳肺结核患者、47例菌阴肺结核患者和15例陈旧性肺结核患者)和健康对照组35名,所有患...目的探讨菌量负荷、疾病活动性、影像学累及范围、外周血淋巴细胞计数等因素对全血γ干扰素释放试验结果的影响。方法选取肺结核患者106例(包括44例菌阳肺结核患者、47例菌阴肺结核患者和15例陈旧性肺结核患者)和健康对照组35名,所有患者(健康对照者)抽取外周血并以肝素抗凝分别与结核分枝杆菌特异抗原分泌抗原靶-6(ESAT-6)、ESAT-6/培养滤过蛋白-10(CFP-10)融合抗原、PPD共同孵育,并用ELISA的方法检测血浆中IFN-γ的含量,各组间差异的比较应用Mann-Whitney U检验,P<0.05为差异有统计学意义。结果抗原刺激后分泌IFN-γ量的中位数在菌阳组和菌阴组之间差异无统计学意义[ESAT-6(114.7 pg/ml vs 82 pg/ml,Z=-0.500,P>0.05),ESAT-6/CFP-10(3488 pg/ml vs 2350 pg/ml,Z=-0.949,P>0.05),PPD(4514 pg/ml vs4326 pg/ml,Z=-0.822,P>0.05)];ESAT-6和ESAT-6/CFP-10抗原刺激后分泌IFN-γ量的中位数在菌阴组和陈旧性肺结核组之间差异无统计学意义[ESAT-6(82 pg/ml vs 137 pg/ml,Z=-0.781,P>0.05),ESAT-6/CFP-10(2350 pg/ml vs 1784 pg/ml,Z=-1.685,P>0.05)],ESAT-6抗原刺激后分泌IFN-γ量的中位数在菌阳组和陈旧性肺结核组之间差异无统计学意义(114.7 pg/ml vs 137 pg/ml,Z=-0.757,P>0.05),但ESAT-6/CFP-10融合抗原刺激后分泌IFN-γ量的中位数在菌阳组和陈旧性肺结核组之间差异有统计学意义(3488 pg/ml vs 1784 pg/ml,Z=-0.242,P<0.05);ESAT-6、ESAT-6/CFP-10融合抗原刺激后分泌IFN-γ量的中位数在肺部病变累及少和肺部病变累及多之间差异有统计学意义[ESAT-6(117 pg/ml vs 42 pg/ml,Z=-2.341,P<0.05),ESAT-6/CFP-10(3055pg/ml vs 1562.5 pg/ml,Z=-2.850,P<0.05)];ESAT-6、ESAT-6/CFP-10融合抗原、PPD抗原刺激后分泌IFN-γ量的中位数在外周血淋巴细胞≥1.0×109/L和<1.0×109/L之间差异有统计学意义[ESAT-6(97.5 pg/ml vs 48 pg/ml,Z=-2.745,P<0.05),ESAT-6/CFP-10(3082 pg/ml vs 1190 pg/ml,Z=-2.911,P<0.05),PPD(4322 pg/ml vs 3200 pg/ml,Z=-2.216,P<0.05)]。结论基于RD1区的抗原刺激后外周血分泌IFN-γ的量不受菌量负荷的影响,但可能受到外周血淋巴细胞绝对值和病变累及范围的影响。展开更多
文摘Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.
文摘Background：Interferon-gamma release assay （IGRA） has been used in latent tuberculosis （TB） infection and TB diagnosis,but the results from different high TB-endemic countries are different.The aim of this study was to investigate the value of IGRA in the diagnosis of active pulmonary TB （PTB） in China.Methods：We conducted a large-scale retrospective multicenter investigation to further evaluate the role of IGRA in the diagnosis of active PTB in high TB-epidemic populations and the factors affecting the performance of the assay.All patients who underwent valid T-SPOT.TB assays from December 2012 to November 2015 in six large-scale specialized TB hospitals in China and met the study criteria were retrospectively evaluated.Patients were divided into three groups：Group 1,sputum culture-positive PTB patients,confirmed by positive Mycobacterium tuberculosis sputum culture;Group 2,sputum culture-negative PTB patients;and Group 3,non-TB respiratory diseases.The medical records of all patients were collected.Chi-square tests and Fisher＇s exact test were used to compare categorical data.Multivariable logistic analyses were performed to evaluate the relationship between the results of T-SPOT in TB patients and other factors.Results：A total of 3082 patients for whom complete information was available were included in the investigation,including 905 sputum culture-positive PTB cases,914 sputum cultmre-negative PTB cases,and 1263 non-TB respiratory disease cases.The positive rate of T-SPOT.TB was 93.3% in the culture-positive PTB group and 86.1% in the culture-negative PTB group.In the non-PTB group,the positive rate of T-SPOT.TB was 43.6%.The positive rate of T-SPOT.TB in the culture-positive PTB group was significantly higher than that in the culture-negative PTB group （x2 =25.118,P 〈 0.01）,which in turn was significantly higher than that in the non-TB group （x2 =566.l 16,P 〈 0.01）.The overall results were as follows：sensitivity,89.7%;specificity,56.37%;positive predictive value,74.75%;negative predictive value,79.11%;and accuracy,76.02%.Conclusions：High false-positive rates of T-SPOT.TB assays in the non-TB group limit the usefulness as a single test to diagnose active TB in China.We highly recommend that IGRAs not be used for the diagnosis of active TB in high-burden TB settings.
文摘Objective To compare the diagnostic performance of interferon gamma releasing assays(T-SPOT.TB)and adenosine deaminase(ADA)in pleural tuberculosis,and therefore to evaluate the value of T-SPOT.TB in a high tuberculosis burden country.Methods From June 2011to November 2012,111 patients with pleural fluid in Beijing Chest Hospital,Capital Medical University
文摘Background: Oman is a high-income, low prevalent country for tuberculosis disease. Although the rates have remained static over the last decade, the country is aiming for Tuberculosis (TB) elimination. Household contacts of pulmonary TB (PTB) patients form a high-risk group of susceptible individuals who could remain reservoirs of active disease. Objective: A retrospective study was conducted to estimate the prevalence of latent TB infection by Tuberculin Skin Test (TST) or Interferon-Gamma Release Assay (IGRA) screening tests among the household contacts of Omani patients with pulmonary tuberculosis. Design: A cross-sectional survey conducted between 2017 and 2018 of TB cases and their contacts in Muscat Governorate, Oman. Results: Out of the 278 contacts identified, 188 contacts fulfilled the inclusion criteria and were enrolled into the study. The prevalence of Latent Tuberculosis Infection (LTBI) was 22.8% (95% CI: 17.0 - 29.5) among household contacts. We found higher proportions of LTBI among females than males (28.7% vs. 15%, p = 0.027). Those who were exposed to Acid Fast Bacilli (AFB) smear positive cases were more likely to be LTBI (28.7% versus 15% in smear negative cases;p = 0.047). We also found an increasing trend of infection (32.3%) in the oldest age group (46 - 80 years). Conclusion: Besides children, female household contacts and older age contacts should be prioritized for screening as they are more likely to be infected and develop active disease.
文摘Objective: This study aimed to determine prevalence of latent tuberculosis infection among medical students and tuberculosis exposure at the health facilities. Methods: A cross-section of study year 1(n=68) and year 5(n=75) medical students in a local university were recruited for latent tuberculosis infection testing using QuantiFERON-TB Gold Plus and a questionnaire analyzed for multivariate risk. Results: The majority of the study were vaccinated with BCG. None of year 1 medical students were positive for latent tuberculosis infection, however, six(8.0%) year 5 students were tested positive for latent tuberculosis infection. A higher incidence of year 5 medical students claimed to be exposed to tuberculosis at health facility(65.3% vs. 4.4%) and a higher percentage reported contact with tuberculosis case over the preceding year compared to year 1 students(30.7% vs. 8.8%). Conclusion: We observed a higher incidence of latent tuberculosis infection and higher exposure to tuberculosis in health facilities among year 5 medical students. Baseline screening and monitoring for progression to tuberculosis infection may benefit tuberculosis management programs.
文摘Most people with latent Mycobacterium tuberculosis infection can partly develop active tuberculosis (TB). Therefore, diagnosis of this condition bears significance in early TB prevention. To date, the main methods for diagnosis of latent TB infection (LTBI) include tuberculin skin test and interferon γ release test. These two methods feature their own advantages and disadvantages. Although new diagnostic markers continually emerge, no uniform diagnostic criteria are available for TB detection. This study summarizes several methods for diagnosis of LTBI and new related markers and their application value in clinical practice.
文摘结核分支杆菌复合群引起的人和动物结核病,对人类健康及畜牧业发展造成了严重的威胁,早期诊断对于结核病的防控至关重要。在结核病众多诊断方法中,免疫学诊断方法中γ干扰素释放试验具有很好的应用前景。γ干扰素释放试验刺激抗原以结核菌素(purified protein derivative,PPD)为主,然而PPD抗原成分复杂,诊断特异性和敏感性有待提高,因此寻找可以代替PPD的特异性刺激抗原成为了研究热点。论文系统综述了近年来报道用于γ干扰素释放试验的刺激抗原,重点概述了刺激抗原的免疫特性、刺激效果以及各类刺激抗原的优势、局限性和应用前景,以期为人和动物结核病的诊断及防控提供参考。
文摘目的探讨菌量负荷、疾病活动性、影像学累及范围、外周血淋巴细胞计数等因素对全血γ干扰素释放试验结果的影响。方法选取肺结核患者106例(包括44例菌阳肺结核患者、47例菌阴肺结核患者和15例陈旧性肺结核患者)和健康对照组35名,所有患者(健康对照者)抽取外周血并以肝素抗凝分别与结核分枝杆菌特异抗原分泌抗原靶-6(ESAT-6)、ESAT-6/培养滤过蛋白-10(CFP-10)融合抗原、PPD共同孵育,并用ELISA的方法检测血浆中IFN-γ的含量,各组间差异的比较应用Mann-Whitney U检验,P<0.05为差异有统计学意义。结果抗原刺激后分泌IFN-γ量的中位数在菌阳组和菌阴组之间差异无统计学意义[ESAT-6(114.7 pg/ml vs 82 pg/ml,Z=-0.500,P>0.05),ESAT-6/CFP-10(3488 pg/ml vs 2350 pg/ml,Z=-0.949,P>0.05),PPD(4514 pg/ml vs4326 pg/ml,Z=-0.822,P>0.05)];ESAT-6和ESAT-6/CFP-10抗原刺激后分泌IFN-γ量的中位数在菌阴组和陈旧性肺结核组之间差异无统计学意义[ESAT-6(82 pg/ml vs 137 pg/ml,Z=-0.781,P>0.05),ESAT-6/CFP-10(2350 pg/ml vs 1784 pg/ml,Z=-1.685,P>0.05)],ESAT-6抗原刺激后分泌IFN-γ量的中位数在菌阳组和陈旧性肺结核组之间差异无统计学意义(114.7 pg/ml vs 137 pg/ml,Z=-0.757,P>0.05),但ESAT-6/CFP-10融合抗原刺激后分泌IFN-γ量的中位数在菌阳组和陈旧性肺结核组之间差异有统计学意义(3488 pg/ml vs 1784 pg/ml,Z=-0.242,P<0.05);ESAT-6、ESAT-6/CFP-10融合抗原刺激后分泌IFN-γ量的中位数在肺部病变累及少和肺部病变累及多之间差异有统计学意义[ESAT-6(117 pg/ml vs 42 pg/ml,Z=-2.341,P<0.05),ESAT-6/CFP-10(3055pg/ml vs 1562.5 pg/ml,Z=-2.850,P<0.05)];ESAT-6、ESAT-6/CFP-10融合抗原、PPD抗原刺激后分泌IFN-γ量的中位数在外周血淋巴细胞≥1.0×109/L和<1.0×109/L之间差异有统计学意义[ESAT-6(97.5 pg/ml vs 48 pg/ml,Z=-2.745,P<0.05),ESAT-6/CFP-10(3082 pg/ml vs 1190 pg/ml,Z=-2.911,P<0.05),PPD(4322 pg/ml vs 3200 pg/ml,Z=-2.216,P<0.05)]。结论基于RD1区的抗原刺激后外周血分泌IFN-γ的量不受菌量负荷的影响,但可能受到外周血淋巴细胞绝对值和病变累及范围的影响。
