Background: The diagnostic accuracy of Quantiferon-TB Gold In-Tube (QFT-IT) is uncertain in the pediatric population, while tuberculin skin test (TST) is still conventionally used despite its limitations. The aim of this study was to compare the performance of QFT-IT with TST in a large cohort of children screened for tuberculosis (TB) infection because of contact tracing, suspected TB, arrival from endemic country or immunosuppressive therapy. Methods: A retrospective analysis was conducted on 517 children 0-14 years of age evaluated at the pediatric unit of the S. Orsola-Malpighi University Hospital of Bologna, Italy; 366 of them were also tested with TST. Results were analyzed for Calmette-Guérin bacillus vaccination, country of origin, reason for testing, diagnosis and age. Results: The overall agreement between the 2 tests was 89.9%, but it was highly affected by Calmette-Guérin bacillus vaccination (P <.0001). According to diagnosis and age, QFT-IT detected latent tuberculous infection cases better than TST in all age groups. Sensitivity for diagnosing active TB in symptomatic children was higher for QFT-IT than TST (93.3% vs. 86.5%), especially in children younger than 2 years, while specificity was high for both tests (99.3% and 98.8%, respectively). Low rate of indeterminate QFT-IT results (3.9%) was not differently distributed among age groups, but was associated with diagnosis of TB exclusion (P < 0.0001), mainly pneumonia (35%), and to Italian children (P = 0.0024). Conclusions: Despite the concern about the use of QFT-IT in children because of their immature immune system, our results suggest the preferential use of QFT-IT as a support tool for diagnosis and management of TB, even in infants.

Petrucci, R., Lombardi, G., Corsini, I., Bacchi Reggiani, M.L., Visciotti, F., Bernardi, F., et al. (2017). Quantiferon-TB Gold In-Tube Improves Tuberculosis Diagnosis in Children. THE PEDIATRIC INFECTIOUS DISEASE JOURNAL, 36(1), 44-49 [10.1097/INF.0000000000001350].

Quantiferon-TB Gold In-Tube Improves Tuberculosis Diagnosis in Children

LOMBARDI, GIULIA;CORSINI, ILARIA;BACCHI REGGIANI, MARIA LETIZIA;VISCIOTTI, FRANCESCA;BERNARDI, FILIPPO;LANDINI, MARIA PAOLA;CAZZATO, SALVATORE;DAL MONTE, PAOLA
2017

Abstract

Background: The diagnostic accuracy of Quantiferon-TB Gold In-Tube (QFT-IT) is uncertain in the pediatric population, while tuberculin skin test (TST) is still conventionally used despite its limitations. The aim of this study was to compare the performance of QFT-IT with TST in a large cohort of children screened for tuberculosis (TB) infection because of contact tracing, suspected TB, arrival from endemic country or immunosuppressive therapy. Methods: A retrospective analysis was conducted on 517 children 0-14 years of age evaluated at the pediatric unit of the S. Orsola-Malpighi University Hospital of Bologna, Italy; 366 of them were also tested with TST. Results were analyzed for Calmette-Guérin bacillus vaccination, country of origin, reason for testing, diagnosis and age. Results: The overall agreement between the 2 tests was 89.9%, but it was highly affected by Calmette-Guérin bacillus vaccination (P <.0001). According to diagnosis and age, QFT-IT detected latent tuberculous infection cases better than TST in all age groups. Sensitivity for diagnosing active TB in symptomatic children was higher for QFT-IT than TST (93.3% vs. 86.5%), especially in children younger than 2 years, while specificity was high for both tests (99.3% and 98.8%, respectively). Low rate of indeterminate QFT-IT results (3.9%) was not differently distributed among age groups, but was associated with diagnosis of TB exclusion (P < 0.0001), mainly pneumonia (35%), and to Italian children (P = 0.0024). Conclusions: Despite the concern about the use of QFT-IT in children because of their immature immune system, our results suggest the preferential use of QFT-IT as a support tool for diagnosis and management of TB, even in infants.
2017
Petrucci, R., Lombardi, G., Corsini, I., Bacchi Reggiani, M.L., Visciotti, F., Bernardi, F., et al. (2017). Quantiferon-TB Gold In-Tube Improves Tuberculosis Diagnosis in Children. THE PEDIATRIC INFECTIOUS DISEASE JOURNAL, 36(1), 44-49 [10.1097/INF.0000000000001350].
Petrucci, Roberta; Lombardi, Giulia; Corsini, Ilaria; Bacchi Reggiani, Maria Letizia; Visciotti, Francesca; Bernardi, Filippo; Landini, Maria Paola; C...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/592490
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