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Questionable Effectiveness of the QuantiFERON-TB Gold Test (Cellestis) as a Screening Tool in Healthcare Workers

Published online by Cambridge University Press:  02 January 2015

Sumanth Gandra ,
William S. Scott ,
Vijaya Somaraju ,
Huaping Wang ,
Suzanne Wilton  and
Michelle Feigenbaum
Sumanth Gandra*
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois
William S. Scott
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois OSF St. Francis Medical Center, Peoria, Illinois
Vijaya Somaraju
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois OSF St. Francis Medical Center, Peoria, Illinois
Huaping Wang
Affiliation:
University of Illinois College of Medicine at Peoria, Peoria, Illinois OSF St. Francis Medical Center, Peoria, Illinois
Suzanne Wilton
Affiliation:
OSF St. Francis Medical Center, Peoria, Illinois
Michelle Feigenbaum
Affiliation:
OSF St. Francis Medical Center, Peoria, Illinois
*
41 Sheridan Drive #1, Shrewsbury, MA 01545, ([email protected])
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Abstract

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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 12 , December 2010 , pp. 1279 - 1285
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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