1887

Chapter 5 : Diagnosis of Latent Tuberculosis Infection

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in
Zoomout

Diagnosis of Latent Tuberculosis Infection, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817138/9781555815134_Chap05-1.gif /docserver/preview/fulltext/10.1128/9781555817138/9781555815134_Chap05-2.gif

Abstract:

This chapter reviews the tuberculin skin test (TST) and the newer blood tests to detect latent tuberculosis infection (LTBI). TST is still the most widely used and available test for the diagnosis of tuberculous infection. Tuberculous infection with , a cascade of immune responses ensues triggered by activated macrophages and carried out by T cells. Two types of tuberculin preparations have been in use, old tuberculin (OT) and purified protein derivative (PPD). PPD antigen is administered by multiple-puncture tests and the intradermal Mantoux test. The Mantoux test is performed by intradermally injecting 0.1 ml of PPD tuberculin (5 TU) into the skin of the volar aspect of the forearm. A negative reaction to the tuberculin test does not rule out tuberculous infection. A poor technique of administration can result in a falsely negative reaction. Though skin sensitivity usually persists and is lifelong, waning can occur, often with age, resulting in an apparent negative reaction. In such instances reactivity can be accentuated with repeated testing (the booster effect). Two gamma interferon release assays (IGRA) systems using RD1-encoded antigens are currently commercially available for TB detection. An IGRA or a TST may be used without preference for testing recent contacts of persons with infectious pulmonary TB with considerations for follow-up testing. An IGRA or a TST may also be used without preference for periodic screening of persons who might have occupational exposure to with considerations for conversions and reversions.

Citation: Lardizabal A, Reichman L. 2011. Diagnosis of Latent Tuberculosis Infection, p 75-82. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch5

Key Concept Ranking

Enzyme-Linked Immunosorbent Assay
0.46990454
0.46990454
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 1.
Figure 1.

Distribution of reactions to 5 TU of PPD among Alaskans tested in 1962. Reprinted with permission from ( ).

Citation: Lardizabal A, Reichman L. 2011. Diagnosis of Latent Tuberculosis Infection, p 75-82. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 2.
Figure 2.

Distribution of reactions to 5 TU of PPD among white Navy recruits from the state of Georgia, with estimate of proportion infected with . Reprinted with permission from ( ).

Citation: Lardizabal A, Reichman L. 2011. Diagnosis of Latent Tuberculosis Infection, p 75-82. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 3.
Figure 3.

Schema of probable distribution of reactors to 5 TU of PPD in the New York City metropolitan area.

Citation: Lardizabal A, Reichman L. 2011. Diagnosis of Latent Tuberculosis Infection, p 75-82. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 4.
Figure 4.

Schematic representation of three booster effect possibilities. (See text for discussion.)

Citation: Lardizabal A, Reichman L. 2011. Diagnosis of Latent Tuberculosis Infection, p 75-82. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch5
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555817138.ch05
1. American Lung Association. 1974. The Tuberculin Skin Test: Supplement to Diagnostic Standards and Classification of Tuberculosis and Other Mycobacterial Diseases. American Lung Association, Washington, DC.
2. American Thoracic Society. 1981. Diagnostic standards and classification of tuberculosis and other mycobacterial diseases. Am. Rev. Respir. Dis. 123:343358.
3. American Thoracic Society. 1981. The tuberculin skin test. Am. Rev. Respir. Dis. 124:356363.
4. American Thoracic Society. 1992. Control of tuberculosis in the United States. Am. Rev. Respir. Dis. 146:16231633.
5. Brock, I.,, K. Weldingh,, T. Lillebaek,, F. Follmann,, and P. Andersen. 2004. Comparison of a new specific blood test and the skin test in tuberculosis contacts. Am. J. Respir. Crit. Care Med. 170:6569.
6. Centers for Disease Control and Prevention. 1995. Screening for tuberculosis and tuberculosis infection in high-risk populations: recommendations of the Advisory Council for the Elimination of Tuberculosis. MMWR Morb. Mortal. Wkly. Rep. 44(RR-11):1934.
7. Centers for Disease Control and Prevention. 2000. Core Curriculum on Tuberculosis, 4th ed. U.S. Government Printing Office, Washington, DC.
8. Centers for Disease Control and Prevention. 2000. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Morb. Mortal. Wkly. Rep. 49(RR-6):151.
9. Centers for Disease Control and Prevention. 2003. Guidelines for using the QuantiFERON-TB test for diagnosing latent Mycobacterium tuberculosis infection. MMWR Morb. Mortal. Wkly. Rep. 52(RR02):1518.
10. Centers for Disease Control and Prevention. 2010. Decrease in reported tuberculosis cases—United States, 2009. MMWR Morb. Mortal. Wkly. Rep. 59:289294.
11. Diel, R.,, R. Loddenkemper,, K. Meywald-Walter,, S. Niemann,, and A. Nienhaus. 2008. Predictive value of a whole blood IFN-γ assay for the development of active tuberculosis disease after recent infection with Mycobacterium tuberculosis. Am. J. Respir. Crit. Care Med. 177:11641170.
12. Diel, R.,, R. Loddenkemper,, and A. Nienhaus. 2010. Evidence-based comparison of commercial interferon-γ release assays for detecting active TB. Chest doi:10.1378/chest.09-2350.
13. Edwards, P. Q. 1972. Tuberculin negative? N. Engl. J. Med. 286:373374. (Editorial.)
14. Edwards, P. Q.,, G. W. Comstock,, and C. E. Palmer. 1968. Contributions of northern population to the understanding of tuberculin sensitivity. Arch. Environ. Health 17:507.
15. Ewer, K.,, J. Deeks,, L. Alvarez,, G. Bryant,, S. Waller,, P. Andersen,, P. Monk,, and A. Lalvani. 2003. Comparison of T-cell based assay with tuberculin skin testing for the diagnosis of Mycobacterium tuberculosis infection in a school outbreak. Lancet 361:11681173.
16. Hill, P. C.,, R. H. Brooks,, A. Fox,, K. Fielding,, D. J. Jeffries,, D. Jackson-Sillah,, M. D. Lugos,, P. K. Owiafe,, S. A. Donkor,, A. S. Hammond,, J. K. Out,, T. Corrah,, R. A. Adegbola,, and K. P. McAdam. 2004. Large scale evaluation of enzyme-linked immunospot assay and skin test for diagnosis of Mycobacterium tuberculosis infection against a gradient of exposure in The Gambia. Clin. Infect. Dis. 38:966973.
17. Lalvani, A.,, A. A. Pathan,, H. Durkan,, K. A. Wilkinson,, A. Whelan,, J. J. Deeks,, W. H. H. Reece,, M. Latif,, G. Pasvol,, and A. V. Hill. 2001. Enhanced contact tracing and spatial tracking of Mycobacterium tuberculosis infection by enumeration of antigen specific T-cells. Lancet 357:20172021.
18. Mazurek, G. H.,, P. A. LoBue,, C. L. Daley,, J. Bernardo,, A. A. Lardizabal,, W. R. Bishai,, M. F. Iademarco,, and J. S. Rothel. 2001. Comparison of a whole-blood interferon γ assay with tuberculin skin testing for detecting latent Mycobacterium tuberculosis infection. JAMA 286:17401747.
19. Menzies, R.,, and B. Vissandjee. 1992. Effect of Bacille Calmette-Guerin vaccination on tuberculin reactivity. Am. Rev. Respir. Dis. 145:621625.
20. Orme, I. M.,, and A. M. Cooper. 1999. Cytokine/chemokine cascades in immunity to tuberculosis. Immunol. Today 20:307312.
21. Pai, M.,, A. Zwerling,, and D. Menzies. 2008. Systematic review: T-cell-based assays for the diagnosis of latent tuberculosis infection: an update. Ann. Intern. Med. 149:18.
22. Palmer, C. E.,, L. B. Edwards,, and L. Hopwood. 1959. Experimental and epidemiologic basis for the interpretation of tuberculin sensitivity. J. Pediatr. 55:413429.
23. Reichman, L. B.,, and R. O’Day. 1977. The influence of a history of a previous test on the prevalence and size of reaction to tuberculin. Am. Rev. Respir. Dis. 115:737741.
24. Reichman, L. B.,, and R. O’Day. 1978. Tuberculous infection in a large urban population. Am. Rev. Respir. Dis. 117:705712.
25. Richeldi, L.,, K. Ewer,, M. Losi,, B. M. Bergamini,, P. Roversi,, J. Deeks,, L. M. Fabbri,, and A. Lalvani. 2004. T-cell based tracking of multidrug resistant tuberculosis infection after brief exposure. Am. J. Respir. Crit. Care Med. 170:288295.
26. Snider, D. E. 1985. Bacille Calmette-Guerin vaccinations and tuberculin skin tests. JAMA 253:34383439.
27. Streeton, J. A.,, N. Desem,, and S. L. Jones. 1998. Sensitivity and specificity of a gamma interferon blood test tuberculosis infection. Int. J. Tuberc. Lung Dis. 2:443450.
28. Styblo, K. 1980. Recent advances in epidemiological research in tuberculosis. Adv. Tuberc. Res. 20:163.
29. Thompson, N. J.,, J. L. Glasroth,, D. E. Snider,, and L. S. Farer. 1979. The booster phenomenon in serial tuberculin testing. Am. Rev. Respir. Dis. 119:587597.

Tables

Generic image for table
Table 1.

Criteria for tuberculin positivity, by risk group

Citation: Lardizabal A, Reichman L. 2011. Diagnosis of Latent Tuberculosis Infection, p 75-82. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch5

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error