{"title":"ESAT6-CFP10皮肤试验对监狱在押人员潜伏性肺结核感染诊断的准确性","authors":"Xinru Fei, Shanshan Wang, Zhan Wang, Xinsong Hu, Cheng Chen, Limei Zhu, Leonardo Martinez, Peijun Tang, Qiao Liu","doi":"10.1128/spectrum.01500-25","DOIUrl":null,"url":null,"abstract":"<p><p>As an alternative to the tuberculin skin test (TST) or QuantiFERON-TB Gold In-Tube (QFT-GIT), ESAT6-CFP10 (EC) skin test is an emerging screening method; however, its value in the diagnosis of latent tuberculosis infection (LTBI) in detainees is still unclear in China. Newly admitted detainees meeting inclusion criteria were enrolled, with demographic/clinical data collected via structured questionnaires. TST, EC skin test, and QFT-GIT screenings were performed, documenting the diameter of skin indurations and/or redness at injection sites and blistering reactions at injection sites. In total, 1,038 detainees were enrolled in this study from October 2022 to October 2023 with 236 LTBI (22.7%). The positive rate of TST, EC skin test, and QFT-GIT was 18.1%, 10.6% and 11.9%. The area under the curve for EC was 0.820, indicating a strong concordance with QFT-GIT (κ = 0.673). Compared with QFT-GIT, the sensitivity of EC was 66.9%, and the specificity was 97.0%. The mean induration diameter or redness of EC was significantly larger than that of TST (<i>P</i> < 0.001). In the regression model, no history of alcohol consumption (aOR = 0.433, 95% confidence interval [CI]: 0.200, 0.938), no history of surgical trauma (aOR = 0.731, 95% CI: 0.539, 0.991), and no drug use (aOR = 0.473, 95% CI: 0.233, 0.961) was identified as a protective factor for LTBI. The EC demonstrated both high specificity and sensitivity comparable to the QFT-GIT. When screening for LTBI among jail detainees in this setting, particular attention should be given to individuals with a history of alcohol consumption, surgical trauma, and drug use.</p><p><strong>Importance: </strong>Jail detainees represent a vulnerable population with an elevated risk of tuberculosis. The EC skin test demonstrates promising potential as an alternative to traditional diagnostic methods, such as the TST and QFT-GIT assay, for LTBI screening. Targeted screening strategies can facilitate the early detection, diagnosis, and management of LTBI.</p>","PeriodicalId":18670,"journal":{"name":"Microbiology spectrum","volume":" ","pages":"e0150025"},"PeriodicalIF":3.8000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic accuracy of the ESAT6-CFP10 skin test for latent tuberculosis infection among jail detainees.\",\"authors\":\"Xinru Fei, Shanshan Wang, Zhan Wang, Xinsong Hu, Cheng Chen, Limei Zhu, Leonardo Martinez, Peijun Tang, Qiao Liu\",\"doi\":\"10.1128/spectrum.01500-25\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>As an alternative to the tuberculin skin test (TST) or QuantiFERON-TB Gold In-Tube (QFT-GIT), ESAT6-CFP10 (EC) skin test is an emerging screening method; however, its value in the diagnosis of latent tuberculosis infection (LTBI) in detainees is still unclear in China. Newly admitted detainees meeting inclusion criteria were enrolled, with demographic/clinical data collected via structured questionnaires. TST, EC skin test, and QFT-GIT screenings were performed, documenting the diameter of skin indurations and/or redness at injection sites and blistering reactions at injection sites. In total, 1,038 detainees were enrolled in this study from October 2022 to October 2023 with 236 LTBI (22.7%). The positive rate of TST, EC skin test, and QFT-GIT was 18.1%, 10.6% and 11.9%. The area under the curve for EC was 0.820, indicating a strong concordance with QFT-GIT (κ = 0.673). Compared with QFT-GIT, the sensitivity of EC was 66.9%, and the specificity was 97.0%. The mean induration diameter or redness of EC was significantly larger than that of TST (<i>P</i> < 0.001). In the regression model, no history of alcohol consumption (aOR = 0.433, 95% confidence interval [CI]: 0.200, 0.938), no history of surgical trauma (aOR = 0.731, 95% CI: 0.539, 0.991), and no drug use (aOR = 0.473, 95% CI: 0.233, 0.961) was identified as a protective factor for LTBI. The EC demonstrated both high specificity and sensitivity comparable to the QFT-GIT. When screening for LTBI among jail detainees in this setting, particular attention should be given to individuals with a history of alcohol consumption, surgical trauma, and drug use.</p><p><strong>Importance: </strong>Jail detainees represent a vulnerable population with an elevated risk of tuberculosis. The EC skin test demonstrates promising potential as an alternative to traditional diagnostic methods, such as the TST and QFT-GIT assay, for LTBI screening. Targeted screening strategies can facilitate the early detection, diagnosis, and management of LTBI.</p>\",\"PeriodicalId\":18670,\"journal\":{\"name\":\"Microbiology spectrum\",\"volume\":\" \",\"pages\":\"e0150025\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-09-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Microbiology spectrum\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://doi.org/10.1128/spectrum.01500-25\",\"RegionNum\":2,\"RegionCategory\":\"生物学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Microbiology spectrum","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.1128/spectrum.01500-25","RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
Diagnostic accuracy of the ESAT6-CFP10 skin test for latent tuberculosis infection among jail detainees.
As an alternative to the tuberculin skin test (TST) or QuantiFERON-TB Gold In-Tube (QFT-GIT), ESAT6-CFP10 (EC) skin test is an emerging screening method; however, its value in the diagnosis of latent tuberculosis infection (LTBI) in detainees is still unclear in China. Newly admitted detainees meeting inclusion criteria were enrolled, with demographic/clinical data collected via structured questionnaires. TST, EC skin test, and QFT-GIT screenings were performed, documenting the diameter of skin indurations and/or redness at injection sites and blistering reactions at injection sites. In total, 1,038 detainees were enrolled in this study from October 2022 to October 2023 with 236 LTBI (22.7%). The positive rate of TST, EC skin test, and QFT-GIT was 18.1%, 10.6% and 11.9%. The area under the curve for EC was 0.820, indicating a strong concordance with QFT-GIT (κ = 0.673). Compared with QFT-GIT, the sensitivity of EC was 66.9%, and the specificity was 97.0%. The mean induration diameter or redness of EC was significantly larger than that of TST (P < 0.001). In the regression model, no history of alcohol consumption (aOR = 0.433, 95% confidence interval [CI]: 0.200, 0.938), no history of surgical trauma (aOR = 0.731, 95% CI: 0.539, 0.991), and no drug use (aOR = 0.473, 95% CI: 0.233, 0.961) was identified as a protective factor for LTBI. The EC demonstrated both high specificity and sensitivity comparable to the QFT-GIT. When screening for LTBI among jail detainees in this setting, particular attention should be given to individuals with a history of alcohol consumption, surgical trauma, and drug use.
Importance: Jail detainees represent a vulnerable population with an elevated risk of tuberculosis. The EC skin test demonstrates promising potential as an alternative to traditional diagnostic methods, such as the TST and QFT-GIT assay, for LTBI screening. Targeted screening strategies can facilitate the early detection, diagnosis, and management of LTBI.
期刊介绍：
Microbiology Spectrum publishes commissioned review articles on topics in microbiology representing ten content areas: Archaea; Food Microbiology; Bacterial Genetics, Cell Biology, and Physiology; Clinical Microbiology; Environmental Microbiology and Ecology; Eukaryotic Microbes; Genomics, Computational, and Synthetic Microbiology; Immunology; Pathogenesis; and Virology. Reviews are interrelated, with each review linking to other related content. A large board of Microbiology Spectrum editors aids in the development of topics for potential reviews and in the identification of an editor, or editors, who shepherd each collection.
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