Performance of QuantiFERON-TB Gold Plus assays in paediatric tuberculosis: a multicentre PTBNET study
Por:
Buonsenso D, Noguera-Julian A, Moroni R, Hernández-Bartolomé A, Fritschi N, Lancella L, Cursi L, Soler-García a, Krüger R, Feiterna-Sperling C, Sali M, Lo Vecchio A, Scarano S, Hernanz Lobo A, Espiau M, Soriano-Arandes A, Cetin BS, Brinkmann F, Ozere I, Baquero-Artigao F, Tsolia M, Milheiro Silva T, Bustillo-Alonso M, Martín Nalda A, Mancini M, Starshinova A, Ritz N, Velizarova S, Ferreras-Antolín L, Götzinger F, Bilogortseva O, Chechenyeva V, Tebruegge M and Santiago-García B
Publicada:
1 mar 2023
Ahead of Print:
1 oct 2022
Categoría:
Pulmonary and respiratory medicine
Resumen:
Rationale In 2016, a new interferon-gamma release assay (IGRA) was introduced, QuantiFERON-TB Gold Plus (QFT-Plus), claimed to have improved sensitivity in active tuberculosis (TB). Objectives This study aimed to determine the performance of QFT-Plus, compared with previous generation IGRAs and the tuberculin skin test (TST), in children with TB in Europe. Methods Multicentre, ambispective cohort study within the Paediatric Tuberculosis Network European Trials Group (ptbnet), a dedicated paediatric TB research network comprising >300 members, capturing TB cases Measurements and main results 1001 TB cases from 16 countries were included (mean age (IQR) 5.6 (2.4-12.1) years). QFT-Plus was performed in 358, QFT Gold in-Tube (QFT-GIT) in 600, T-SPOT.TB in 58 and TST in 636 cases. The overall test sensitivities were: QFT-Plus 83.8% (95% CI 80.2% to 87.8%), QFT-GIT 85.5% (95% CI 82.7% to 88.3%), T-SPOT.TB 77.6% (95% CI 66.9% to 88.3%) and TST (cut-off >= 10 mm) 83.3% (95% CI 83.3% to 86.2%). There was a trend for tests to have lower sensitivity in patients with miliary and/or central nervous system (CNS) TB (73.1%, 70.9%, 63.6% and 43.5%, respectively), and in immunocompromised patients (75.0%, 59.6%, 45.5% and 59.1%, respectively). Conclusions The results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB.
Filiaciones:
Buonsenso D:
Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Milano, Italy
Center for Global Health Research and Studies, Università Cattolica del Sacro Cuore, Roma, Italia
Noguera-Julian A:
Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
Moroni R:
Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Hernández-Bartolomé A:
Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
Fritschi N:
Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital Basel and Department of Clinical Research, University of Basel, Basel, Switzerland
Lancella L:
Paediatric Infectious Diseases Unit, Bambino Gesù Children Hospital, Rome, Italy
Cursi L:
Paediatric Infectious Diseases Unit, Bambino Gesù Children Hospital, Rome, Italy
Soler-García a:
Malalties Infeccioses i Resposta Inflamatòria Sistèmica en Pediatria, Unitat d'Infeccions, Servei de Pediatria, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
Krüger R:
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, Berlin, Germany
Feiterna-Sperling C:
Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin, Berlin, Germany
Sali M:
Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e perioperatorie - Sezione di Microbiologia, Università Cattolica del Sacro Cuore, Milano, Italy
Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Rome, Italy
Lo Vecchio A:
Department of Translational Medical Sciences, Pediatric Infectious Diseases Unit, University of Naples Federico II, Naples, Italy
Scarano S:
Department of Translational Medical Sciences, Pediatric Infectious Diseases Unit, University of Naples Federico II, Naples, Italy
Hernanz Lobo A:
Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
Espiau M:
Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Soriano-Arandes A:
Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Cetin BS:
Department of Pediatric Infectious Diseases, Erciyes University, Kayseri, Turkey
Brinkmann F:
Department of Paediatric Pulmonology, Children's Hospital, Ruhr-University, Bochum, Germany
Ozere I:
Riga Stradinš University, Riga, Latvia
Baquero-Artigao F:
Red de Investigación Translacional en Infectología Pediátrica, Madrid, Spain
Hospital Infantil La Paz, Madrid, Spain
CIBERINFEC, ISCIII, Madrid, Spain
Tsolia M:
Panagiotis & Aglaia Kyriakou Children's Hospital, Athens, Greece
Milheiro Silva T:
Hospital Dona Estefânia, Lisbon, Portugal
Bustillo-Alonso M:
Hospital Universitario Miguel Servet, Zaragoza, Spain
Martín Nalda A:
Paediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Mancini M:
Ospedale Sant'Orsola, Bologna, Italy
Starshinova A:
St. Petersburg Scientific Research Institute of Phthisiopulmonology, St. Petersburg, Russian Federation
Ritz N:
Mycobacterial and Migrant Health Research Group, University of Basel Children's Hospital Basel and Department of Clinical Research, University of Basel, Basel, Switzerland
Department of Paediatrics and Paediatric Infectious Diseases, Children's Hospital Lucerne Lucerne Cantonal Hospital, Lucerne, Switzerland
Department of Paediatrics, The University of Melbourne, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia
Velizarova S:
Medical University Sofia, Sofia, Bulgaria
Ferreras-Antolín L:
Paediatric Infectious Diseases Unit, St. George's University Hospitals NHS Foundation Trust, London, UK
Götzinger F:
Department of Paediatric and Adolescent Medicine, National Reference Centre for Childhood Tuberculosis, Klinik Ottakring, Vienna, Austria
Bilogortseva O:
Ukraine. Department of Children Phthisiology, National Institution of Phthisiology and Pulmonology of National Academy of Medical sciences of Ukraine, Kiev, Ukraine
Infectious diseases Centre «Clinic for treatment of children with HIV/AIDS» National Specialized Children's Hospital 'OKHMATDYT', Kiev, Ukraine
Chechenyeva V:
Ukraine. Department of Children Phthisiology, National Institution of Phthisiology and Pulmonology of National Academy of Medical sciences of Ukraine, Kiev, Ukraine
Infectious diseases Centre «Clinic for treatment of children with HIV/AIDS» National Specialized Children's Hospital 'OKHMATDYT', Kiev, Ukraine
Tebruegge M:
Department of Infection, Immunity and Inflammation, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
Santiago-García B:
Paediatric Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain. Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Infecciosas {CIBER INFEC), Instituto de Salud Carlos III, Madrid, Spain
Fdn Policlin Univ Gemelli IRCCS, Dept Woman & Child Hlth & Publ Hlth, Rome, Italy.
Univ Cattolica Sacro Cuore, Dipartimento Sci Biotecnol Base Clin, Sez Microbiol, Milan, Italy.
Univ Cattolica Sacro Cuore, Ctr Global Hlth Res & Studies, Rome, Italy.
Inst Recerca Sant Joan de Deu, Malalties Infeccioses Resposta Inflamatoria Sist, Unitat Infecc Serv Pediat, Barcelona, Spain.
Univ Barcelona, Dept Pediatria, Barcelona, Spain.
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain.
Fdn Policlin Univ Gemelli IRCCS, Direzione Sci, Rome, Italy.
Fdn Policlin Univ Gemelli IRCCS, Dept Woman & Child Hlth & Publ Hlth, Rome, Italy
Univ Cattolica Sacro Cuore, Dipartimento Sci Biotecnol Base Clin, Sez Microbiol, Milan, Italy
Univ Cattolica Sacro Cuore, Ctr Global Hlth Res & Studies, Rome, Italy
Inst Recerca Sant Joan de Deu, Malalties Infeccioses Resposta Inflamatoria Sist, Unitat Infecc Serv Pediat, Barcelona, Spain
Univ Barcelona, Dept Pediatria, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain
Fdn Policlin Univ Gemelli IRCCS, Direzione Sci, Rome, Italy
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