Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children

Lewinsohn, David; Leonard, Michael; LoBue, Philip; Cohn, David L.; Daley, Charles L.; Desmond, Ed; Keane, Joseph; Lewinsohn, Deborah A.; Loeffler, Ann M.; Mazurek, Gerald H.; O’Brien, Richard; Pai, Madhukar; Richeldi, Luca; Salfinger, Max; Shinnick, Thomas M.; Sterling, Timothy R.; Warshauer, David M.; Woods, Gail L.

doi:10.1093/cid/ciw694

Cited by 621 publications

(504 citation statements)

References 203 publications

(226 reference statements)

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“…Quantitative QFT-GIT results and CD4+ cell counts in patients with HIV infection were not assessed. Second, we could not evaluate other possible risk factors associated with indeterminate QFT-GIT results, such as specimen collection, long delays in specimen processing, incubator malfunctions, or technical errors [1]. …”

Section: Discussionmentioning

confidence: 99%

“…Interferon-γ (IFN-γ) release assays (IGRAs) are immunologic tests that can help clinicians diagnose tuberculosis (TB) and latent Mycobacterium tuberculosis ( Mtb ) infection by demonstrating the immunologic response to Mtb antigens [1]. The QuantiFERON-TB Gold In-Tube test (QFT-GIT) is an enzyme-linked immunosorbent assay (ELISA) that quantifies the IFN-γ response of fresh whole blood to a cocktail of Mtb antigens (early secretory antigenic target-6 [ESAT-6], culture filtrate protein-10 [CFP-10], and TB7.7), and it has been used widely.…”

Section: Introductionmentioning

confidence: 99%

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Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

Shin

Kim

et al. 2017

PLoS ONE

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BackgroundThe sensitivity of interferon-gamma release assays (IGRAs) in the detection of Mycobacterium tuberculosis infection could be affected by conditions of immune dysregulation. For this reason, diabetes mellitus (DM) may increase the frequency of indeterminate results of IGRAs. However, there have been inconsistent reports of role of DM on indeterminate IGRA results.MethodsWe retrospectively reviewed all patients who underwent QuantiFERON-TB Gold In-Tube testing (QFT-GIT) at Chonnam National University Hospital. We collected the clinical and laboratory data of these patients.ResultsOf all 3,391 subjects, 1,265 (37.3%) had a positive QFT-GIT result, 266 (7.8%) had an indeterminate result, and 1,860 (54.9%) had a negative result. The mean age was 54.8 ± 18.1 years and 55.0% of the patients were male. There were 512 (15.1%) patients with DM. Multivariable analysis revealed that systemic corticosteroid use, tuberculosis, lymphocytopenia, low serum albumin, and high serum C-reactive protein (CRP) levels were significantly associated with indeterminate QFT-GIT results. However, DM was not associated with indeterminate QFT-GIT results (adjusted odds ratio, 0.98; 95% confidence interval, 0.69–1.41; P = 0.939). After propensity score matching, DM was not associated with indeterminate results of QFT-GIT.ConclusionIn this large cohort study, DM does not affect the incidence of indeterminate results of QFT-GIT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

Shin

Kim

et al. 2017

PLoS ONE

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“…85 Advisory bodies have recommended caution when using IGRAs in children <5 years of age due to a lack of data and favor the use of the TST. 86,87 However, increasing experience suggests potential utility in young children, particularly those between 2–5 years of age. 84,88 …”

Section: Diagnosismentioning

confidence: 99%

Tuberculosis in Children

Thomas

2017

Pediatric Clinics of North America

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Synopsis Mycobacterium tuberculosis is the leading cause of death worldwide from a single bacterial pathogen. World Health Organization (WHO) estimates that annually, 1 million children have TB disease and many more harbor a latent form of infection. However, accurate estimates are hindered by under-recognition and challenges in diagnosis; to date, an accurate diagnostic test to confirm TB in children does not exist. TB treatment is lengthy, but outcomes are generally favorable with timely initiation. As we move toward the End TB Strategy, there is an urgent need for improved diagnostics and treatment to prevent the unnecessary morbidity and mortality from TB in children.

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“…23 IGRAs require a single venous blood sample and laboratory processing eight to 30 hours after collection. According to the CDC, to conduct the tests, “Specimens are mixed with peptides that simulate antigens derived from M. tuberculosis and controls.…”

Section: Latent Tuberculosis Infection Risk Assessment Testing and mentioning

confidence: 99%

“…It also depends on the person’s risk of being infected with tuberculosis bacteria and the risk of progression to tuberculosis disease if infected. 23 …”

Section: Latent Tuberculosis Infection Risk Assessment Testing and mentioning

confidence: 99%

Ce

Parmer

Allen

Walton

2017

AJN, American Journal of Nursing

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Nurses play a critical role in the diagnosis and treatment of tuberculosis and in the prevention of tuberculosis transmission through infection control practices. To eliminate tuberculosis in the United States, however, an expanded approach to testing and treating people with latent tuberculosis infection must be implemented. Recently, the U.S. Preventive Services Task Force (USPSTF) issued a new recommendation statement on latent tuberculosis infection testing that expands nurses’ opportunities to identify at-risk populations for tuberculosis prevention. In combination with newer testing methodologies and shorter treatment regimens, implementation of the USPSTF recommendation has the potential to remove previously existing barriers to screening and treatment of both patients and health care providers. This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents preventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF recommendation’s applicability to public health and primary care practice in the United States.

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Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children

Abstract: These guidelines are not intended to impose a standard of care. They provide the basis for rational decisions in the diagnosis of tuberculosis in the context of the existing evidence. No guidelines can take into account all of the often compelling unique individual clinical circumstances.

Cited by 621 publications

References 203 publications

Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

Impact of diabetes mellitus on indeterminate results of the QuantiFERON TB Gold In-Tube test: A propensity score matching analysis

Tuberculosis in Children

Ce

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