title: Automation of an interferon-γ release assay and comparison to the tuberculin skin test for screening basic military trainees for Mycobacterium tuberculosis infection.
abstract: We automated portions of the QuantiFERON-TB Gold In-Tube test (QFT-GIT) and assessed its quality when performed concurrently with the tuberculin skin test (TST) among U.S. Air Force basic military trainees (BMTs). The volume of blood collected for QFT-GIT was monitored. At least one of the three tubes required for QFT-GIT had blood volume outside the recommended 0.8- to 1.2-mL range for 688 (29.0%) of 2,373 subjects who had their blood collected. Of the 2,124 subjects who had TST and QFT-GIT completed, TST was positive for 0.6%; QFT-GIT was positive for 0.3% and indeterminate for 2.0%. Among 2,081 subjects with completed TST and determinate QFT-GIT results, overall agreement was 99.5% but positive agreement was 5.6%. Specificity among the 1,546 low-risk BMTs was identical (99.7%). Indeterminate QFT-GIT results were 2.7 times more likely when mitogen tubes contained >1.2 mL blood than when containing 0.8- to 1.2-mL blood. Automation can facilitate QFT-GIT completion, especially if the recommended volume of blood is collected. Mycobacterium tuberculosis infection prevalence among BMTs based on TST and QFT-GIT is similar and low. Selectively testing those with significant risk may be more appropriate than universal testing of all recruits.
authors.affiliation: Epidemiology Consult Services, U.S. Air Force School of Aerospace Medicine, 2510 Fifth Street, Building 840, W318K, Wright-Patterson AFB, OH 45433-7913.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Goodwin
authors.affiliation: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), CDC Mail Stop E-10, 1600 Clifton Road, NE, Atlanta, GA 30333.
authors.forename: Gerald H
authors.initials: GH
authors.lastname: Mazurek
authors.affiliation: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), CDC Mail Stop E-10, 1600 Clifton Road, NE, Atlanta, GA 30333.
authors.forename: Brandon H
authors.initials: BH
authors.lastname: Campbell
authors.affiliation: Epidemiology Consult Services, U.S. Air Force School of Aerospace Medicine, 2510 Fifth Street, Building 840, W318K, Wright-Patterson AFB, OH 45433-7913.
authors.forename: Jamaria
authors.initials: J
authors.lastname: Bohanon
authors.affiliation: Department of Occupational Medicine/TB Prevention/Deployment Medicine, Wilford Hall Medical Center, Reid Clinic, Lackland Air Force Base, TX 78236.
authors.forename: Kevin B
authors.initials: KB
authors.lastname: West
authors.affiliation: Epidemiology Consult Services, U.S. Air Force School of Aerospace Medicine, 2510 Fifth Street, Building 840, W318K, Wright-Patterson AFB, OH 45433-7913.
authors.forename: James J
authors.initials: JJ
authors.lastname: Bell
authors.affiliation: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), CDC Mail Stop E-10, 1600 Clifton Road, NE, Atlanta, GA 30333.
authors.forename: Richard
authors.initials: R
authors.lastname: Powell
authors.affiliation: Division of Tuberculosis Elimination, Centers for Disease Control and Prevention (CDC), CDC Mail Stop E-10, 1600 Clifton Road, NE, Atlanta, GA 30333.
authors.forename: Sean
authors.initials: S
authors.lastname: Toney
authors.affiliation: Diagnostic Division, Grifols USA, LLC, Doral, FL 33172.
authors.forename: John A
authors.initials: JA
authors.lastname: Morris
authors.affiliation: Epidemiology Consult Services, U.S. Air Force School of Aerospace Medicine, 2510 Fifth Street, Building 840, W318K, Wright-Patterson AFB, OH 45433-7913.
authors.forename: Grover K
authors.initials: GK
authors.lastname: Yamane
authors.affiliation: Epidemiology Consult Services, U.S. Air Force School of Aerospace Medicine, 2510 Fifth Street, Building 840, W318K, Wright-Patterson AFB, OH 45433-7913.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Sjoberg
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis*; D001331:Automation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D059425:Interferon-gamma Release Tests / Q000379:methods*; D008297:Male; D008889:Military Personnel; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D015995:Prevalence; D012189:Retrospective Studies; D014374:Tuberculin Test / Q000379:methods*; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial