title: [EXPERIENCE WITH THE NEW SKIN TEST DIASKINTEST® USED TO DIAGNOSE RESPIRATORY TUBERCULOSIS IN CHILDREN AND ADOLESCENTS IN A TUBERCULOSIS UNIT].
abstract: Seventy-two patients aged 4 to years, who had first detected X-ray changes in the lung or intrathoracic lymph nodes and had received no antituberculous drugs before study, were examined to estimate the sensitivity and specificity of the new skin test Diaskintest® (recombinant CFR-10--ESAT-6 protein produced by Escherichia coli BL21(DE3)/pCFP--ESAT). According to the results of examination and treatment, the patients were divided into 3 groups: 1) 52 patients with active respiratory tuberculosis; 2) 7 patients with residual changes after spontaneously cured tuberculosis; 3) 13 with nontuberculous diseases. By comparing the results of the skin tuberculin test (Mantoux test with 2 TE PPD-L) and Diaskintest®, the mean size of an infiltrate and the percentage of hyperergic, negative and doubtful reactions were estimated in each group, which allowed evaluation of the sensitivity and specificity of the new skin test Diaskintest® versus the conventional skin tuberculin test. The sensitivity of Diaskintest® (Group 1) was 96.2%; false-negative responses with doubtful results being kept in mind were 3.8% (2 patients with limited tuberculous lung lesion). Diaskintest® was the most sensitive in patients with infiltrative pulmonary tuberculosis, in those with disseminated processes or lung tissue decay, as the hyperergic reaction to Diaskintest® just in these cases was more than 80.0%. Its specificity (Group 3) was 84.6%; false-positive results were seen in 15.4%. Determining the activity of first detected posttuberculosis changes--Ghon's focus (Group 2) indicated that Diaskintest® was of more informative value than the Mantoux test with 2 TE PPD-L since its speci- ficity in this case (a negative result) was 100.0%, and that of the Mantoux tuberculin test was 14.3%. The high sensitivity (96.2%) and specificity (84.6%) of the new skin test Diaskintest® permit its use in the comprehensive examination of patients with clinical and radiological signs in a specialized hospital, contributing to the shorter duration of differential diagnosis in difficult diagnostic cases. Diaskintest® enables one to rule out the activity of the process with a high assurance in patients with first detected post-tuberculosis changes.
mesh_terms: D000293:Adolescent; D000942:Antigens, Bacterial / Q000276:immunology / Q000494:pharmacology; D001426:Bacterial Proteins / Q000276:immunology / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D057186:Comparative Effectiveness Research; D005260:Female; D006763:Hospitals, Chronic Disease / Q000706:statistics & numerical data; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D007202:Indicators and Reagents / Q000494:pharmacology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D062072:Patient Acuity; D015203:Reproducibility of Results; D012426:Russia / Q000453:epidemiology; D012680:Sensitivity and Specificity; D014373:Tuberculin / Q000276:immunology / Q000494:pharmacology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C117940:CFP-10 protein, Mycobacterium tuberculosis; C093276:ESAT-6 protein, Mycobacterium tuberculosis; D007202:Indicators and Reagents; D014373:Tuberculin