The clinical utility of tuberculin skin tests: a single-center experience.

Pub Date : 2022-07-01 DOI:10.25100/cm.v53i3.5055
Fatih Üzer, Şükriye Öner, Yasin Gokmen, Ömer Yeşil, Tülay Özdemir
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Abstract

Background: Tuberculin skin test (TST) has played an essential in the diagnosis of latent tuberculosis infection (LTBI) for nearly a century.

Objective: This study aimed to investigate the general characteristics of patients tested with TST in a tertiary hospital within two years.

Methods: All patients who were evaluated to screen for tuberculosis and received a TST were included. The Mantoux method was used for TST administration.

Results: A total of 661 patients, 345 (52.2%) men and 316 (47.8%) women, with a mean age of 43.0 ±15.9 years, were included in the study. Accordingly, TST was performed prior to anti-TNF biological agent therapy for 50% (331) of the participants, for LTBI screening before solid organ and/or hematological stem cell transplantation for 20.4% (135), for screening following contact with tuberculosis for 25.1% (166), for screening of healthcare professionals for 1.1% (7), and medical report for 3.3% (22). 2.7% of the patients who took TST were diagnosed with active tuberculosis (14 with pulmonary tuberculosis and 4 with extrapulmonary tuberculosis). QuantiFERON-TB Gold (QFT) test was performed in 332 (50.2%) patients with anergic TST results. According to TST and QFT test results, 28.3% (187) of the patients were started on tuberculosis prophylaxis.

Conclusion: While TST is most performed for LTBI screening prior to biological agent therapy, almost one-fourth of patients taking TST require tuberculosis prophylaxis. On the other hand, about half of the patients require an additional QFT test.

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结核菌素皮肤试验的临床应用:单中心经验
背景:近一个世纪以来,结核菌素皮肤试验(TST)在诊断潜伏性结核感染(LTBI)方面发挥了重要作用。目的:探讨某三级医院两年内TST检测患者的一般特征。方法:所有接受结核筛查和TST检查的患者均纳入研究。TST给药采用Mantoux法。结果:共纳入661例患者,其中男性345例(52.2%),女性316例(47.8%),平均年龄(43.0±15.9岁)。因此,50%(331)的参与者在抗肿瘤坏死因子生物制剂治疗前进行了TST, 20.4%(135)的参与者在实体器官和/或血液干细胞移植前进行了LTBI筛查,25.1%(166)的参与者在接触结核病后进行了筛查,1.1%(7)的参与者进行了医疗专业人员筛查,3.3%(22)的参与者进行了医疗报告筛查。接受TST治疗的患者中有2.7%被诊断为活动性结核(14例合并肺结核,4例合并肺外结核)。对332例(50.2%)有过敏TST结果的患者进行QuantiFERON-TB Gold (QFT)试验。TST和QFT检测结果显示,28.3%(187人)的患者开始了结核病预防。结论:虽然TST在生物制剂治疗前用于LTBI筛查,但几乎四分之一接受TST的患者需要结核病预防。另一方面,大约一半的患者需要额外的QFT测试。
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