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Indeterminate QuantiFERON-TB gold in-tube assay results in children: possible association with procedural specimen
Duc-Hieu P Bui1, Andrea T Cruz, Edward A Graviss
1From the *University of Texas-Houston School of Public Health; †Department of Pediatrics, Baylor College of Medicine; and ‡Department of Pathology and Genomic Medicine, The Methodist Hospital Research Institute, Houston, TX.
Insights
Indeterminate QuantiFERON-TB Gold assays were common in children (31%). Inpatient status significantly increased the risk of indeterminate results, suggesting issues with specimen handling.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Diagnostics
Background:
- Tuberculosis (TB) infection screening in children is crucial.
- QuantiFERON-TB Gold (QFT-GIT) is a common diagnostic tool.
- Indeterminate results can hinder accurate diagnosis.
Purpose of the Study:
- To identify factors associated with indeterminate QuantiFERON-TB Gold results in a pediatric population.
- To investigate the impact of clinical factors on QFT-GIT assay validity.
Main Methods:
- Retrospective analysis of QFT-GIT results in 182 children.
- Statistical analysis to determine associations between indeterminate results and variables like age, gender, comorbidities, and inpatient status.
Main Results:
- 31% (56/182) of QFT-GIT assays were indeterminate.
- Indeterminate results were strongly associated with inpatient status (OR: 11.7, 95% CI: 3.9-34.9).
- No significant association was found with age, gender, or medical comorbidities.
Conclusions:
- Indeterminate QFT-GIT results are frequent in pediatric patients, particularly inpatients.
- Specimen handling and procedural factors likely contribute to indeterminate results.
- Enhanced training on specimen collection and handling may reduce indeterminate QFT-GIT assay rates in children.
Abstract:
Fifty-six of 182 (31%) children had indeterminate QuantiFERON assays. Indeterminate assays were associated with inpatient status [odds ratios (OR): 11.7, 95% confidence interval 3.9-34.9], but not with age, gender or medical comorbidities. This indicates that indeterminates may be due to specimen handling, and proper procedural training may be necessary to decrease indeterminate QuantiFERON results.
