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환자와 의료기관 종사자에서 QuantiFERON-TB Gold-Plus 양성 패턴과 추적 결과 분석

Analysis of Positive Patterns and Follow-up Results of the QuantiFERON-TB Gold-Plus Test in the Screening of Patients and Healthcare Workers

김한아|문희원|허미나|윤여민|신은주|서종도
대한진단검사의학회 (Korean Society For Laboratory Medicine)|2023.04|Laboratory Medicine Online|제13권 제2호|pp. 85-90|DOI 10.47429/lmo.2023.13.2.85

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키워드

Latent tuberculosis infectionReversionQuantiFERON-TB Gold-Plus

초록

배경: 잠복 결핵의 조기 발견과 치료는 결핵 발병률을 줄이는데 필수적이다. QuantiFERON-TB Gold-Plus (QFT-Plus; Qiagen, Germany)는 TB1과 TB2 튜브를 이용하여 CD8+과 CD4+ T 세포 면역 반응을 검출한다. 본 연구에서는 환자와 의료기관 종사자 검진에서 QFT-Plus의 양성 패턴과 추적 결과를 분석하였다. 방법: 2019년 2월부터 2022년 3월까지 건국대학교병원에서 총 6,594명(환자 4,765명과 의료기관 종사자 1,829명)을 대상으로 QFT-Plus를 시행하였다. 의료기관 종사자군과 검사 목적에 따라 분류한 환자군의 양성률과 양성 패턴(TB1 단독 양성, TB2 단독 양성, TB1과 TB2 양성) 및 각 군별 추적 검사 결과를 분석하였다. 결과: 환자군과 의료기관 종사자군의 양성률은 각각 16.0%와 1.4%였다. 의료기관 종사자군은 하나의 튜브에서 양성 비율이 환자군보다 높았다(P=0.0035, chi-square test). 추적 검사를 한 83명의 양성자 중에서, 4명의 의료기관 종사자 모두 반전(양성에서 음성) 결과를 보였다. 반전율은 TB2단독 양성군에서 가장 높았으며(80%), 하나의 튜브에서만 양성을 보인 군의 반전율이 두 개의 튜브 모두 양성을 보인 군보다 높았다(53.3% vs. 19.1%, P=0.0061, chi-square test). 결론: 하나의 튜브, 특히 TB2 단독 양성인 경우에 높은 반전율을 보여 QFT-Plus 에서TB2 단독 양성의 임상적 유용성에 대한 추가적인 평가가 필요할 것으로 사료된다.

Abstract

Background: The early detection of latent tuberculosis infection is essential for reducing the incidence of tuberculosis (TB). The QuantiFERON-TB Gold-Plus (QFT-Plus; Qiagen, Germany) detects both CD8+ and CD4+ T-cell-mediated immune responses using TB1 and TB2 tubes. This study aimed to analyze the positive pattern and follow-up results of QFT-Plus when screening patients and healthcare workers (HCWs). Methods: A total of 6,594 (4,765 patients and 1,829 HCWs) were tested using QFT-Plus from February 2019 to March 2022 at the Konkuk University Medical Center. We analyzed the positive rates and patterns in the two groups and divided them into subgroups based on the positive patterns (TB1-only, TB2-only, and TB1 and TB2) and the purpose of the test. Serial results were analyzed for each group. Results: The positivity rates in the patients and HCWs were 16.0% and 1.4%, respectively. The single-tube positivity rate (TB1-only or TB2-only) was higher in HCWs than in patients (P=0.0035). Among the 83 subjects testing positive in the available serial QFT-Plus test results, all four HCWs showed reversion (positive to negative results). The reversion rate was highest in the TB2-only group (80%), and was significantly higher in the single-tube positive group than the both-tube (TB1 and TB2) positive group (53.3% vs. 19.1%, P=0.0061). Conclusions: Subjects in the single-tube positive group, especially the TB2-only positive group, showed a higher reversion rate than subjects in the both-tube positive group. Further studies are needed to evaluate the clinical usefulness of TB2-only positivity in the QFT-Plus.

참고문헌 (21)

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관련 논문AI추천

QuantiFERON-TB Gold PLUS versus QuantiFERON- TB Gold In-Tube test for diagnosing tuberculosis infectionKyung-Wook Jo, Soo Han Kim, Tae Sun Shim대한내과학회 · The Korean Journal of Internal Medicine2020 · 제35권 제2호일개 병원 내 의료종사자에서의 결핵 접촉자 조사김연재, 김태희, 배현주, 오성희, 장윤숙, 정선주대한소아감염학회 · Pediatric Infection and Vaccine2016 · 제23권 제2호폐외 결핵 진단에서 2개의 전혈 인터페론 감마 측정법의 유용성 비교이혁, 김경희, 박소영, 서정민, 우수미, 윤늘봄, 이성우, 정동식, 정진규, 한송이대한내과학회 · 대한내과학회지2011 · 제81권 제4호Qualitative and quantitative results of interferon-γ release assays for monitoring the response to anti-tuberculosis treatment박이내, 심태선대한내과학회 · The Korean Journal of Internal Medicine2017 · 제32권 제2호항결핵항체 검사와 인터페론감마 분비능 측정법을 조합한 결핵 진단 방법의 임상적 유용성김미혜, 서관용, 원동일대한진단검사의학회 · Laboratory Medicine Online2011 · 제1권 제1호Indeterminate T-SPOT.TB Test Results in Patients with Suspected Extrapulmonary Tuberculosis in Routine Clinical Practice김선미, 김성한, 김양수, 박기호, 박수진, 우준희, 이상오, 이유미, 최상호대한감염학회 · Infection and Chemotherapy2013 · 제45권 제1호

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