QuantiFERON-TB gold plus is a more sensitive screening tool than QuantiFERON-TB gold in-tube for latent tuberculosis infection among older adults in long-term care facilities
Journal
Journal of Clinical Microbiology
Journal Volume
56
Journal Issue
8
Pages
e00427-18
Date Issued
2018
Author(s)
Abstract
We investigated the prevalence of latent tuberculosis infection (LTBI) among the residents in seven long-term care facilities (LTCFs) located in different regions of Taiwan and compared the performance of two interferon gamma release assays, i.e., QuantiFERON-TB Gold In-Tube (QFT-GIT) and QuantiFERON-TB Gold Plus (QFT-Plus) for screening LTBI. We also assessed the diagnostic performance against a composite reference standard (subjects with persistent-positive, transient-positive, and negative results from QFTs during reproducibility analysis were classified as definite, possible, and not LTBI, respectively). Two hundred forty-four residents were enrolled, and 229 subjects were included in the analysis. The median age was 80 years (range, 60 to 102 years old), and 117 (51.1%) were male. Among them, 66 (28.8%) and 74 (32.3%) subjects had positive results from QFT-GIT and QFT-Plus, respectively, and the results for 215 (93.9%) subjects showed agreement. Using the composite reference standard, 66 (28.8%), 11 (4.8%), and 152 (66.4%) were classified as definite, possible, and not LTBI, respectively. For definite LTBI, the sensitivity, specificity, positive predictive value, and negative predictive value of QFT-GIT were 89.4%, 95.7%, 89.4%, and 95.7%, respectively, and those for QFT-Plus were 100.0%, 95.1%, 89.2%, and 100.0%, respectively. The sensitivity of QFT-GIT decreased gradually with patient age. Compared to QFT-GIT, QFT-Plus displayed significantly higher sensitivity (100.0% versus 89.4%, P 0.013) and similar specificity (95.1% versus 95.7%). In conclusion, a high prevalence of LTBI was found among elders in LTCFs in Taiwan. The new QFT-Plus test demonstrated a higher sensitivity than QFT-GIT in the older adults in LTCFs. ? 2018 American Society for Microbiology. All Rights Reserved
SDGs
Other Subjects
adult; aged; Article; controlled study; diagnostic test accuracy study; female; health care facility; human; intermethod comparison; latent tuberculosis; long term care; major clinical study; male; predictive value; prevalence; priority journal; reproducibility; screening test; sensitivity and specificity; Taiwan; very elderly; age; comparative study; home for the aged; interferon gamma release assay; latent tuberculosis; mass screening; middle aged; procedures; standard; standards; statistics and numerical data; Age Factors; Aged; Aged, 80 and over; Female; Homes for the Aged; Humans; Interferon-gamma Release Tests; Latent Tuberculosis; Male; Mass Screening; Middle Aged; Prevalence; Reference Standards; Sensitivity and Specificity; Taiwan
Type
journal article