Diagnostic usefulness of the QuantiFERON-TB gold in-tube test (QFT-GIT) for tuberculous vertebral osteomyelitis

Sungim Choi, Kyung Hwa Jung, Hyo Ju Son, Seung Hyun Lee, Jung Min Hong, Min Chul Kim, Min Jae Kim, Yong Pil Chong, Heungsup Sung, Sang Oh Lee, Sang Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung Han Kim

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Interferon (IFN)-γ-releasing assay for diagnosing tuberculosis (TB) has shown promise; however, there are only a few reports on usefulness of the QuantiFERON-TB Gold In-Tube test (QFT-GIT) for diagnosing TB vertebral osteomyelitis. Methods: All patients presenting at a tertiary hospital between January 2010 and July 2016 with suspected TB vertebral osteomyelitis were retrospectively enrolled to evaluate the diagnostic performance of QFT-GIT. We used QFT-GIT to measure the IFN-γ response to ESAT-6, CFP-10 and TB7.7. Results: A total of 141 patients were enrolled; 32 (23%) were categorized as having confirmed TB, (1%) as probable TB, 14 (10%) as possible TB and 93 (66%) as not TB. Of these, 16 patients with probable and possible TB were excluded from the final analysis. Chronic granulomas with/without necrosis, acid-fast bacilli stain, M. tuberculosis polymerase chain reaction and cultures for M. tuberculosis were positive in 14 (44%), 12 (38%), 22 (69%) and 28 (88%) patients, respectively, among the 32 patients with confirmed TB. The overall sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for a positive result, and likelihood ratio for a negative result of the QFT-GIT for TB vertebral osteomyelitis were 91% (95% confidence interval [CI], 75–98%), 65% (95% CI, 54–75%), 50% (95% CI, 42–58%), 95% (95% CI, 86–98%), 2.59 (95% CI, 1.89–3.55) and 0.14 (95% CI, 0.05–0.43), respectively. Conclusion: The QFT-GIT appears to be a useful adjunct test for diagnosing TB vertebral osteomyelitis because the negative test results may be useful for excluding a diagnosis of active TB vertebral osteomyelitis.

Original languageEnglish
Pages (from-to)346-351
Number of pages6
JournalInfectious Diseases
Volume50
Issue number5
DOIs
StatePublished - 4 May 2018

Keywords

  • Interferon-gamma releasing assay
  • Tuberculosis
  • Vertebral osteomyelitis

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