T-SPOT.TB is a novel screening method for Mycobacterium tuberculosis infection. However, it is controversial whether T-SPOT.TB should become an alternative method to the tuberculin skin test (TST) for screening M. tuberculosis infections. The present study aimed to evaluate this issue based on the retrospective analysis of clinical cases. TST and T-SPOT.TB tests were used on patients with suspected M. tuberculosis infection on admission. Demographic data and clinical information, including previous history of M. tuberculosis infection, were collected. A total of 118 patients were included in the analysis, among whom 30 (25.4%) were diagnosed with active M. tuberculosis infection, and seven patients (5.9%) were currently receiving immunosuppressive treatment. The overall sensitivity and specificity of the TST were 76.7 and 77.3%, respectively, while they were 88.3 and 68.1%, respectively, for the T-SPOT.TB test. Patients with large TST indurations had a higher number of gamma interferon-producing T cells among peripheral blood mononuclear cells compared with those of TST-negative patients. In conclusion, the T-SPOT.TB test had a higher sensitivity than the TST, but the difference was not statistically significant. Neither the T-SPOT.TB test nor the TST was sufficiently accurate to detect active M. tuberculosis infection. Materials and methods Participants and data collection. A retrospective analysis was performed on patients diagnosed at the Respiratory Department of Ningbo First Hospital (Ningbo, China) between October 2016 and 2017. A total of 118 patients who were suspected of active TB infection on admission were included in the analysis. Each patient was subjected to the TST as well as the T-SPOT.TB test. The patients' demographics and clinical information, including previous history of TB, were collected. Definitions and diagnoses. Final diagnoses were made considering all clinical, radiological, microbiological and pathological information. Patients who had clinical, bacteriological and/or
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