Using of T-Spot.TB and Mantoux tests in diagnosis of M. tuberculosis infection in BCG vaccinated children aged five and younger

Ozere, Iveta; Skenders, Ģirts; Līduma, Iveta; Bobrikova, Olga; Lauska, Zita; Skangale, Anita; Jagmane, Anita; Kalniņa, Vita; Leimane, Vaira

doi:10.2478/v10046-010-0001-1

Abstract

Infection with M. tuberculosis (MT) is difficult to diagnose in young BCG (Bacillus Calmette-Guérin) vaccinated children using Mantoux test alone, as a positive test result may be due to infection with MT and previous BCG vaccination. We aimed to test the T-SPOT. TB test for BCG-vaccinated children aged five and younger in two groups — with or without contact with an active tuberculosis (ATB) patient. Prospectively a study group of 121 children (having contact with ATB patient) and a control group of 64 children (without known contact with ATB patient) were examined using Mantoux and T-SPOT. TB tests. The T-SPOT. TB test was positive in 66 (54.5%) study group children and in 2 (3.1%) control group children (P < 0.01). Induration in the Mantoux test ≥ 10 mm was observed in 62 (91.0%) of 68 T-SPOT. TB positive children, and 34 (29.1%) of 117 T-SPOT. TB negative children (P < 0.01). In the group with a negative T-SPOT. TB result boosting of the Mantoux test was observed in 21 (66%) of 32 children who had received repeated Mantoux testing before being included in the study. According to the results, the application of the T-SPOT. TB test is reasonable for primary contact children evaluation and follow-up contact children for whom primary tests did not confirm infection with MT.

References

Anonymous (2000). Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR (Morbidity and Mortality Weekly Report), 49 (RR-6), 24.
Search in Google Scholar
Anonymous (2005). Centers for Disease Control and Prevention. Guidelines for the Investigation of Contact Persons with Infectious Tuberculosis. MMWR, Recommendations and Reports, 54 (RR15), 1-37.
Search in Google Scholar
Anonymous (2006a). Oxford Immunotec Limited. T-SPOT.TB. Package insert: 3.
Search in Google Scholar
Anonymous (2006b). World Health Organisation. Guidance for national tuberculosis programmes on the management of tuberculosis in children. WHO/HTM/TB/2006.371. WHO/FCH/CAH/2006.7, 16-19.
Search in Google Scholar
Bozaykut, A., Ozahi Ipek, I., Ozkars, M. Y., Pulat Seren L., Atay, E., Atay, Z. (2002). Effect of BCG vaccine on tuberculin skin tests in 1-6-year-old children. Acta Paediatrica, 91(2), 235-238.10.1111/j.1651-2227.2002.tb01701.x
Search in Google Scholar
Brock, I., Weldingh, K., Lillebaek, T., Follmann, F., Anderson, P. (2004). Comparison to Tuberculin Skin Test and New Specific Blood Test in Tuberculosis Contacts. Amer. J. Respir. Crit. Care Med., 170, 65-69.10.1164/rccm.200402-232OC
Search in Google Scholar
Chapman, A. L., Muncanta, M., Wilkinson, K. A., Pathan, A. A., Ewer, K., Ayles, H., Reece, W. H., Mwinga, A., Godfrey-Faussett, P., Lalvani, A. (2002). Rapid detection of active and latent tuberculosis infection in HIV-positive individuals by enumeration of Mycobacterium tuberculosis-specific T cells. AIDS, 16, 2285-2293.10.1097/00002030-200211220-00008
Search in Google Scholar
Ewer, K., Deeks, J., Alvarez, L., Bryant, G., Waller, S., Andersen, P., Monk, P., Lalvani, A. (2003). Comparison of T-cell-based assay with tuberculin skin test for diagnosis of Mycobacterium tuberculosis infection in a school tuberculosis outbreak. Lancet, 361(9364), 1168-1173.
Search in Google Scholar
Ewer, K., Millington, K. A., Deeks, J., Alvarez, L., Bryant, G., Lalvani, A. (2006). Dynamic antigen-specific T-cell responses after point-source exposure to Mycobacterium tuberculosis. Amer. J. Respir. Crit. Care Med., 174, 831-839.10.1164/rccm.200511-1783OC
Search in Google Scholar
Ferrara, G., Losi, M., D'Amico, R., Roversi, P., Piro, R., Meacci, M., Meccugni, B., Dori, I. M., Andreani, A., Bergamini, M. B., Mussini, C., Rumpianesi, F., Fabbri, L M., Richeldi, L. (2006). Use in routine clinical practice of two commercial blood tests for diagnosis of infection with Mycobacterium tuberculosis: A prospective study. The Lancet, 367(9519), 1328-1334.
Search in Google Scholar
Hill, P. C., Brookes, R. H., Adetifa, I. M. O., Fox, A., Jackson-Sillah, D., Lugos, M. D., Marshall, R. J., Howie S. R. C., Corrah, T., Jeffries, D. J., Adegbola, R. A., McAdam, K. P. W. J. (2006). Comparison of enzyme-linked immunospot assay and tuberculin skin test in healthy children exposed to Mycobacterium tuberculosis. Pediatrics, 117(5), 1542-1548.10.1542/peds.2005-2095
Search in Google Scholar
Karalliedde, S., Katugaha., L. P., Urogada, C. G. (1987). Tuberculin response of Sri Lankan children after BCG vaccination at birth. Tubercle, 68, 33-38.10.1016/0041-3879(87)90005-5
Search in Google Scholar
Lalvani, A. (2003). Spotting latent infection: The path to better tuberculosis control. Thorax, 58, 960-918.10.1136/thorax.58.11.916174649814586040
Search in Google Scholar
Lalvani, A., Millington, K. A. (2007). T cell-based diagnosis of childhood tuberculosis infection. Curr. Opin. Infect. Dis., 20, 264-271.10.1097/QCO.0b013e32813e3fd817471036
Search in Google Scholar
Lalvani, A., Pathan, A. A., McShane, H., Wilkinson, R. J., Latif, M., Conlon, C. P., Pasvol, G., Hill, A. V. (2001). Rapid detection of Mycobacterium tuberculosis infection by enumeration of antigen specific T cells. Amer. J. Respir. Crit. Care Med., 163, 824-828.10.1164/ajrccm.163.4.200910011282752
Search in Google Scholar
Lee, J. Y., Choi, H. J., Park, I-N., Hong, S-B., Oh, Y-M., Lim, C-M., Lee, S. D., Koh, Y., Kim, W. S., Kim, W. D., Shim, T. S. (2006). Comparison of two commercial interferon-γ assays for diagnosing Mycobacterium tuberculosis infection. Eur. Respir. J., 28, 24-30.10.1183/09031936.06.0001690616611658
Search in Google Scholar
Liebeschuetz, S., Bamber, S., Ewer, K., Deeks, J., Pathan, A. A., Lalvani, A. (2004). Diagnosis of tuberculosis in South African children with a T-cell based assay: A prospective cohort study. Lancet, 364, 2196-2203.10.1016/S0140-6736(04)17592-2
Search in Google Scholar
Marais, B. J., Gie, R. P., Schaaf, H S., Hesseling, A. C., Obihara, C. C., Starke, J. J., Enarson, D. A., Donald, P. R., Beyers, N. (2004). The natural history of childhood inthra-thoracic tuberculosis: A critical review of literature from pre-chemotherapy era. Int. J. Tuberc. Lung. Dis., 8(4), 392-402.
Search in Google Scholar
Meier, T., Eulenbruch, H. P., Wrighton-Smith, P., Enders, G., Regnath, T. (2005). Sensitivity of a new commercial enzyme-linked immunospot assay (T SPOT-TB) for diagnosis of tuberculosis in clinical practise. Eur. J. Clin. Microbiol. Inf. Dis., 24(8), 529-536.10.1007/s10096-005-1377-8
Search in Google Scholar
Menzies, R., Vissandjee, B. (1992) Effect of bacilli Calmette-Guerin vaccination on tuberculin reactivity. Amer. Rev. Respir. Dis., 145, 621-625.
Search in Google Scholar
Morantz, C. A. (2006). Practise Guidelines. Guidelines Released for Investigation of Potential Contact with Infectious Tuberculosis. Amer. Family Physician, 73(8), 1-9.
Search in Google Scholar
Pai, M. (2005). Alternatives to the Tuberculin Skin Test: Interferon-γ Assays in the Diagnosis of Mycobacterium tuberculosis Infection. Ind. J. Med. Microbiol., 23(3), 151-158.10.1016/S0255-0857(21)02584-6
Search in Google Scholar
Pathan, A. A., Wilkinson, K. A., Klenerman, P., McShane, H., Davidson, R. N., Pasvol, G., Hill, A. V., Lalvani, A. (2001). Direct ex vivo analysis of antigen-specific IFN-gamma-secreting CD4 cells in Mycobacterium tuberculosis infected individuals: Association with clinical disease state and effect of treatment. J. Immunol., 167, 5217-5225.10.4049/jimmunol.167.9.521711673535
Search in Google Scholar
Richeldi, L. (2006) An update on the diagnosis of tuberculosis infection. Amer. J. Respir. Crit. Care Med., 174, 736-742.
Search in Google Scholar
Richeldi, L., Ewer, K., Losi, M., Bergamini, B. M., Roversi, P., Deeks, J., Fabbri, L. M., Lalvani, A. (2004). T cell-based tracking of multidrug resistant tuberculosis infection after brief exposure. Amer. J. Respir. Crit. Care Med., 170, 288-295.10.1164/rccm.200403-307OC15130907
Search in Google Scholar
Wang, L., Turner, M. O., Elwood, R. K., Schulzer, M., FitzGerald, J. M. (2002). A meta-analysis of the effect of bacilli Calmette Guerin vaccination on tuberculin skin test measurements. Thorax, 57, 804-809.10.1136/thorax.57.9.804174643612200526
Search in Google Scholar
Zellweger, J-P., Zellweger, A., Ansermet, S., de Senarclens, B., Wringhton-Smith, P. (2005). Contact tracing using a new T-cell-based test: Better correlation with tuberculosis exposure than the tuberculin skin test. Int. J. Tuberc. Lung Dis., 9(11), 1242-1124.
Search in Google Scholar

Using of T-Spot.TB and Mantoux tests in diagnosis of M. tuberculosis infection in BCG vaccinated children aged five and younger

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