Clinical evaluation of the QuantiFERON-TB Gold test in patients with non-tuberculous mycobacterial disease

Int J Tuberc Lung Dis. 2009 Nov;13(11):1422-6.

Abstract

Objective: To evaluate the clinical usefulness of the QuantiFERON TB-2G (QFT-2G) test in patients with non-tuberculous mycobacterial (NTM) disease without a previous history of tuberculosis (TB).

Methods: The study consisted of 214 patients with NTM disease who satisfied the diagnostic guidelines of the American Thoracic Society.

Results: The causative microorganism was Mycobacterium avium in 83 patients, M. intracellulare in 80, M. kansasii in 33, M. marinum in 12, M. szulgai in 3, M. abscessus in 2 and M. chelonei in 1. The positive response rate of QFT-2G test result was 2% in 163 patients with M. avium-intracellulare complex (MAIC) disease, 52% in 33 with M. kansasii disease, 58% in 12 with M. marinum disease, 33% in 3 with M. szulgai disease, 0% in two with M. abscessus disease and 0% in one with M. chelonei disease. The positivity of the QFT-2G test was 52% in patients with NTM disease, thought to be because NTM possesses common M. tuberculosis-specific antigens.

Conclusions: Although QFT-2G may be a useful diagnostic method to differentiate TB from MAIC disease, there are several problems to be resolved before it can be used as a diagnostic method for NTM disease (M. kansasii disease), including the determination of the positive cut-off level for QFT-2G test.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay*
  • Female
  • Humans
  • Interferon-gamma / blood*
  • Japan
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Mycobacterium avium-intracellulare Infection / diagnosis
  • Mycobacterium avium-intracellulare Infection / microbiology
  • Nontuberculous Mycobacteria / immunology*
  • Predictive Value of Tests
  • Prospective Studies
  • Reagent Kits, Diagnostic*
  • Sensitivity and Specificity
  • Tuberculosis / diagnosis
  • Tuberculosis / microbiology

Substances

  • Biomarkers
  • Reagent Kits, Diagnostic
  • Interferon-gamma