Diagnosis of Latent Tuberculous Infection
Authors: Thomas C. Bailey
Journal: Annals of Internal Medicine (2016)

Letters20 September 2016Diagnosis of Latent Tuberculous InfectionThomas C. Bailey, MDThomas C. Bailey, MDFrom Washington University School of Medicine, St. Louis, Missouri.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0194 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Collins and colleagues' article (1) about interferon-γ release assay (IGRA) testing versus tuberculin skin testing (TST) for diagnosing latent TB infection poses many problems. First, they define newly infected TB contacts by TST conversion and compare IGRA performance against this, as though the TST were a gold standard. There is no gold standard for identifying latent TB infection.Second, they dismiss the specificity of IGRA testing for persons vaccinated with bacille Calmette–Guérin (BCG) on the assertion that it is “of little clinical significance when vaccination is administered before the first year of life.” Because of the booster ...References1. Collins LF, Geadas C, Ellner JJ. Diagnosis of latent tuberculosis infection: too soon to pull the plug on the tuberculin skin test. Ann Intern Med. 2016;164:122-4. [PMID: 26642354]. doi:10.7326/M15-1522 LinkGoogle Scholar2. Menzies D. What does tuberculin reactivity after bacille Calmette-Guérin vaccination tell us? Clin Infect Dis. 2000;31 Suppl 3:S71-4. [PMID: 11010826] CrossrefMedlineGoogle Scholar3. King TC, Upfal M, Gottlieb A, Adamo P, Bernacki E, Kadlecek CP, et al. T-SPOT.TB Interferon-γ release assay performance in healthcare worker screening at nineteen U.S. hospitals. Am J Respir Crit Care Med. 2015;192:367-73. [PMID: 26017193] doi:10.1164/rccm.201501-0199OC CrossrefMedlineGoogle Scholar4. Doberne D, Gaur RL, Banaei N. Preanalytical delay reduces sensitivity of QuantiFERON-TB gold in-tube assay for detection of latent tuberculosis infection. J Clin Microbiol. 2011;49:3061-4. [PMID: 21697332] doi:10.1128/JCM.01136-11 CrossrefMedlineGoogle Scholar5. Gaur RL, Pai M, Banaei N. Impact of blood volume, tube shaking, and incubation time on reproducibility of QuantiFERON-TB gold in-tube assay. J Clin Microbiol. 2013;51:3521-6. [PMID: 23966505] doi:10.1128/JCM.01627-13 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Washington University School of Medicine, St. Louis, Missouri.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L16-0194. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDiagnosis of Latent Tuberculosis Infection: Too Soon to Pull the Plug on the Tuberculin Skin Test Lauren F. Collins , Carolina Geadas , and Jerrold J. Ellner Diagnosis of Latent Tuberculous Infection Lauren F. Collins , Carolina Geadas , and Jerrold J. Ellner Diagnosis of Latent Tuberculous Infection Colin L. Crawford Metrics 20 September 2016Volume 165, Issue 6Page: 447-448KeywordsBacille calmette guerinConflicts of interestDisclosureHealth carePopulation statisticsSkin infectionsSkin testsSpecificitySpecimen preparation and treatmentTuberculin ePublished: 20 September 2016 Issue Published: 20 September 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...