Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis

A. C C Carvalho, R. F. Schumacher, S. Bigoni, E. Soncini, L. Notarangelo, A. Apostoli, C. Bonfanti, D. Cirillo, P. Mantegani, F. Porta, M. Comelli, A. Matteelli

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. Methods: Children who were exposed to a contagious TB case underwent serial QuantiFERON® TB Gold In-Tube (QFT-GIT) and T-SPOT ®.TB (T-SPOT) testing. Results: Eighteen children were tested. At the first testing, only two children (11 %) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 %) than with T-SPOT (12 %). In the multivariable analysis, a statistically significant association of lymphocyte count 3 (p <0.00005) and low age (p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT (p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. Conclusion: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficient children. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.

Original languageEnglish
Pages (from-to)827-831
Number of pages5
JournalInfection
Volume41
Issue number4
DOIs
Publication statusPublished - Aug 2013

Fingerprint

Interferon-gamma Release Tests
Hematology
Pulmonary Tuberculosis
Tuberculosis
Gold
Lymphopenia
Lymphocyte Count
Infection
Sensitivity and Specificity

Keywords

  • Children
  • Interferon-gamma release assays
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis. / Carvalho, A. C C; Schumacher, R. F.; Bigoni, S.; Soncini, E.; Notarangelo, L.; Apostoli, A.; Bonfanti, C.; Cirillo, D.; Mantegani, P.; Porta, F.; Comelli, M.; Matteelli, A.

In: Infection, Vol. 41, No. 4, 08.2013, p. 827-831.

Research output: Contribution to journalArticle

Carvalho, ACC, Schumacher, RF, Bigoni, S, Soncini, E, Notarangelo, L, Apostoli, A, Bonfanti, C, Cirillo, D, Mantegani, P, Porta, F, Comelli, M & Matteelli, A 2013, 'Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis', Infection, vol. 41, no. 4, pp. 827-831. https://doi.org/10.1007/s15010-013-0450-y
Carvalho, A. C C ; Schumacher, R. F. ; Bigoni, S. ; Soncini, E. ; Notarangelo, L. ; Apostoli, A. ; Bonfanti, C. ; Cirillo, D. ; Mantegani, P. ; Porta, F. ; Comelli, M. ; Matteelli, A. / Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis. In: Infection. 2013 ; Vol. 41, No. 4. pp. 827-831.
@article{59496a7869834f0db8de3e0d4c26462b,
title = "Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis",
abstract = "Background: Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. Methods: Children who were exposed to a contagious TB case underwent serial QuantiFERON{\circledR} TB Gold In-Tube (QFT-GIT) and T-SPOT {\circledR}.TB (T-SPOT) testing. Results: Eighteen children were tested. At the first testing, only two children (11 {\%}) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 {\%}) than with T-SPOT (12 {\%}). In the multivariable analysis, a statistically significant association of lymphocyte count 3 (p <0.00005) and low age (p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT (p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. Conclusion: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficient children. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.",
keywords = "Children, Interferon-gamma release assays, Tuberculosis",
author = "Carvalho, {A. C C} and Schumacher, {R. F.} and S. Bigoni and E. Soncini and L. Notarangelo and A. Apostoli and C. Bonfanti and D. Cirillo and P. Mantegani and F. Porta and M. Comelli and A. Matteelli",
year = "2013",
month = "8",
doi = "10.1007/s15010-013-0450-y",
language = "English",
volume = "41",
pages = "827--831",
journal = "Infection",
issn = "0300-8126",
publisher = "Urban und Vogel GmbH",
number = "4",

}

TY - JOUR

T1 - Contact investigation based on serial interferon-gamma release assays (IGRA) in children from the hematology-oncology ward after exposure to a patient with pulmonary tuberculosis

AU - Carvalho, A. C C

AU - Schumacher, R. F.

AU - Bigoni, S.

AU - Soncini, E.

AU - Notarangelo, L.

AU - Apostoli, A.

AU - Bonfanti, C.

AU - Cirillo, D.

AU - Mantegani, P.

AU - Porta, F.

AU - Comelli, M.

AU - Matteelli, A.

PY - 2013/8

Y1 - 2013/8

N2 - Background: Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. Methods: Children who were exposed to a contagious TB case underwent serial QuantiFERON® TB Gold In-Tube (QFT-GIT) and T-SPOT ®.TB (T-SPOT) testing. Results: Eighteen children were tested. At the first testing, only two children (11 %) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 %) than with T-SPOT (12 %). In the multivariable analysis, a statistically significant association of lymphocyte count 3 (p <0.00005) and low age (p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT (p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. Conclusion: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficient children. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.

AB - Background: Interferon-gamma release assays (IGRAs) have high specificity and sensitivity for the diagnosis of tuberculosis (TB) infection. However, their role as a screening tool in children with immunodeficiency disorders is still unclear. In the present study, we performed a contact investigation using serial IGRAs on children with immunodeficiency conditions exposed to a contagious TB patient. Methods: Children who were exposed to a contagious TB case underwent serial QuantiFERON® TB Gold In-Tube (QFT-GIT) and T-SPOT ®.TB (T-SPOT) testing. Results: Eighteen children were tested. At the first testing, only two children (11 %) were positive to T-SPOT. Indeterminate results were more frequent with QFT-GIT (35 %) than with T-SPOT (12 %). In the multivariable analysis, a statistically significant association of lymphocyte count 3 (p <0.00005) and low age (p = 0.03) with indeterminate results for the QFT-GIT test but not for T-SPOT (p = 0.10 and p = 0.88, respectively) was found. At the end of October 2012, 15 of the 18 children were alive and none developed active TB disease. Conclusion: T-SPOT provided more determinate results and was less influenced by low age and lymphocytopenia than QFT-GIT in this population of immunodeficient children. These findings suggest that T-SPOT is a more accurate test for the identification of TB infection in young children with lymphocytopenia and should be preferred to QFT-GIT under such specific conditions.

KW - Children

KW - Interferon-gamma release assays

KW - Tuberculosis

UR - http://www.scopus.com/inward/record.url?scp=84881117814&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881117814&partnerID=8YFLogxK

U2 - 10.1007/s15010-013-0450-y

DO - 10.1007/s15010-013-0450-y

M3 - Article

C2 - 23575516

AN - SCOPUS:84881117814

VL - 41

SP - 827

EP - 831

JO - Infection

JF - Infection

SN - 0300-8126

IS - 4

ER -