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Poor correlation between tuberculin skin tests and interferon-γ assays in close contacts of patients with multidrug-resistant tuberculosis

Authors

  • KYUNG-WOOK JO,

    1. Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center
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  • KYEONGMAN JEON,

    1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine
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  • YOUNG AE KANG,

    1. Department of Internal Medicine, Yonsei University College of Medicine
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  • WON-JUNG KOH,

    1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine
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  • KYUNG CHAN KIM,

    1. Department of Pulmonary and Critical Care Medicine, Catholic University of Daegu Hospital
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  • YEE HYUNG KIM,

    1. Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong
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  • KWANG HA YOO,

    1. Department of Pulmonary and Critical Care Medicine, Konkuk University, School of Medicine
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  • SEUNG HEON LEE,

    1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University of Medicine, Busan
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  • JAE-JOON YIM,

    1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine
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  • SANG BONG CHOI,

    1. Division of Respirology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine
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  • WON-IL CHOI,

    1. Department of Internal Medicine, Dongsan Hospital, Keimyung University School of Medicine
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  • JAE CHOL CHOI,

    1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University School of Medicine
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  • YONG IL HWANG,

    1. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
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  • TAE SUN SHIM

    Corresponding author
    1. Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center
      Tae Sun Shim, Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-Dong, Songpa-gu, Seoul 138-736, South Korea. Email: shimts@amc.seoul.kr
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  • Kyung-Wook Jo and Kyeongman Jeon contributed equally to this work.

Tae Sun Shim, Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-Dong, Songpa-gu, Seoul 138-736, South Korea. Email: shimts@amc.seoul.kr

ABSTRACT

Background and Objective:  The results of tuberculin skin tests (TST) and QuantiFERON TB-Gold In-Tube (QFT-GIT) assays were compared in close contacts of patients with multidrug-resistant tuberculosis (MDR-TB).

Methods:  Close contacts of patients with bacteriologically confirmed MDR-TB (n = 101) were assessed. Most contacts were members of the households of patients, and 79 (78.2%) had received Bacille Calmette-Guerin (BCG) vaccination. Samples from each contact were tested using the TST and the QFT-GIT assay on the same day, and the concordance between these results was assessed using kappa (κ) coefficients.

Results:  Forty-eight subjects (47.5%) showed positive responses on TST, using a 10-mm induration cut-off, and 54 (53.5%) were positive for the QFT-GIT assay. Of the 48 individuals who were TST positive, 34 (70.8%) were positive for the QFT-GIT assay. Of the 53 subjects who were TST negative, 33 (62.5%) were negative for the QFT-GIT assay. The overall agreement between the two tests (κ coefficient) was 0.33. The κ coefficient was higher in the 22 subjects who had not received BCG vaccination (κ = 0.48) than in the 79 subjects who had received BCG vaccination (κ = 0.29).

Conclusion:  The TST and QFT-GIT assays showed poor correlation in close contacts of patients with MDR-TB, especially those contacts who had received BCG vaccination.

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