Indeterminate test results of T-SPOT.TB performed under routine field conditions.
Interferon-gamma release assays for the diagnosis of tuberculosis (TB) can give indeterminate results. The prevalence of indeterminate test results (ITRs) among T-SPOT.TB tests was assessed. A retrospective analysis of samples processed in 2005 was performed. ITRs were assessed by age, sex, immunosuppression, distance to the laboratory and season. A subgroup of tests performed for specific indications (contact tracing, migrants with positive tuberculin skin test, TB suspects and immunosuppression) were analysed separately. Of a total of 1,429 tests, 49 (3.4%) were indeterminate. ITRs were significantly associated with old age (>75 versus 5-75 yrs; odds ratio (OR) 7.97, 95% confidence interval (CI) 3.968-15.438) and the season during which samples were transported (autumn and winter versus spring and summer; OR 3.47, 95% CI 1.753-7.514). The incidence of ITR was 302 (2.0%) among TB contacts, 75 (1.6%) among immigrants, 156 (3.0%) in TB suspects and 32 (3.0%) among immunosuppressed patients. Sex, young age and distance to the laboratory were not associated with the rate of ITR. Of the 13 tests with ITR that were repeated, 10 gave a clear positive or negative result. Indeterminate test results with T-SPOT.TB under routine conditions were infrequent and more common in individuals aged >75 yrs than in children and younger adults. The incidence of indeterminate test results was low and similar among healthy tuberculosis contacts, immigrants with a positive tuberculin skin test, tuberculosis suspects and the immunosuppressed. The conditions of transportation may influence the incidence of indeterminate test results.
Dept of Ambulatory Care and Community Medicine, University of Lausanne, Rue du Bugnon 44, 1011 Lausanne, Switzerland.
P
P
Beffa
A
A
Zellweger
J-P
JP
Janssens
P
P
Wrighton-Smith
J-P
JP
Zellweger
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000032:analysis / Q000378:metabolism*; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011933:Reagent Kits, Diagnostic / Q000382:microbiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000378:metabolism / Q000382:microbiology*; D014376:Tuberculosis / Q000097:blood / Q000175:diagnosis*
D011933:Reagent Kits, Diagnostic; D007371:Interferon-gamma