The sensitivity of an interferon-γ release assay in microbiologically confirmed pediatric tuberculosis.
This study aimed at determining the sensitivity of a whole blood interferon-γ release assay (IGRA) among children with microbiologically confirmed tuberculosis in a high-burden country. Children with a diagnosis of tuberculosis based on clinical and radiographic assessment were tested with an IGRA in addition to microbiologic examination of appropriate specimens for acid-fast bacilli, mycobacterial rRNA, and observation for growth of Mycobacterium tuberculosis on appropriate culture media. Of the 405 children with a clinical diagnosis of tuberculosis, 91 (22.5 %) had microbiologically confirmed tuberculosis, of whom 81 were tested with an IGRA. A positive result was obtained in 43 (sensitivity 53.1 %, 95 % confidence interval 42.3 to 63.6 %), uninfluenced by age, sex, or disease manifestation.


CONCLUSIONS
The sensitivity of a whole blood interferon-γ release assay in microbiologically confirmed pediatric tuberculosis was low. An IGRA cannot, thus, be used as rule-in test, but it might be useful to rule in tuberculosis among children in whom tuberculosis is notoriously difficult to confirm microbiologically.
Institute of Infectious Diseases, University of Bern, Friedbühlstrasse 51, 3010, Bern, Switzerland, kurt.schopfer@bluewin.ch.
Kurt
K
Schopfer
Hans L
HL
Rieder
Thomas
T
Bodmer
Jacqueline F
JF
Steinlin-Schopfer
Yay
Y
Chantana
Peter
P
Studer
Denis
D
Laurent
Beat
B
Richner
D002160:Cambodia; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000097:blood; D059425:Interferon-gamma Release Tests / Q000379:methods*; D008297:Male; D009169:Mycobacterium tuberculosis / Q000276:immunology* / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology
D007371:Interferon-gamma