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Journal of Occupational Medicine and Toxicology

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Open Access 01-12-2016 | Research

Using IFN-gamma release assay to confirm tuberculin skin test improves the screening of latent tuberculosis infection in Italian healthcare workers

Authors: Raffaela Olivieri, Sara Scarnera, Annalisa Ciabattini, Giulia De Vuono, Pietro Manzi, Gianni Pozzi, Giuseppe Battista, Donata Medaglini

Published in: Journal of Occupational Medicine and Toxicology | Issue 1/2016

Abstract

Background

Healthcare workers (HCWs) represent a tuberculosis (TB) risk group for a wide range of tasks in healthcare, even in countries with low TB incidence, like Italy. Latent Tuberculosis Infection (LTBI) screening programs are an important tool for TB prevention in these setting.

Methods

A retrospective study under a LTBI screening program among HCWs at the Siena University Hospital (Italy), was conducted between September 2011 and July 2015. Tuberculin Skin Test (TST) was used as a first level examination; all TST-positive cases were tested with QuantiFERON-TB Gold In-Tube (QFT-GIT) test, together with a group of TST-negative subjects.

Results

Among the 2136 HCWs screened, 144 (6.7 %) were TST-positive and therefore tested with QFT-GIT, confirming a positive result in 36 cases (25 %). Agreement between two tests was poor (k = 0.092; 95 %, Confidence Interval [CI]- 0.048–0.136, p = 0.002). Among TST-positive cases, discordant results occurred more frequently in BCG vaccinated than unvaccinated HCWs (86.3 %, p < 0.001). The probability of a QFT-GIT-positive result increased according to the TST diameter (p = 0.001). No putative risk factor was associated with LTBI occurrence.

Conclusions

The use of QFT-GIT test as a second step in TST-positive cases offers an appropriate tool for LTBI detection, especially among BCG-vaccinated HCWs.

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Title: Using IFN-gamma release assay to confirm tuberculin skin test improves the screening of latent tuberculosis infection in Italian healthcare workers
Authors: Raffaela Olivieri
Sara Scarnera
Annalisa Ciabattini
Giulia De Vuono
Pietro Manzi
Gianni Pozzi
Giuseppe Battista
Donata Medaglini
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Occupational Medicine and Toxicology / Issue 1/2016
Electronic ISSN: 1745-6673
DOI: https://doi.org/10.1186/s12995-016-0117-6

At a glance: The STEP trials

Springer Medicine

Using IFN-gamma release assay to confirm tuberculin skin test improves the screening of latent tuberculosis infection in Italian healthcare workers

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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