2005. T-SPOT®.TB Test for Latent Tuberculosis Infection Diagnosis and Treatment Guidance in Thai Healthcare Professionals
Session: Poster Abstract Session: Diagnostics: Bacteria and Mycobacteria
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Poster IDWeek 2018 number 2005.pdf (459.2 kB)
  • Background: Data on efficacy of T-SPOT®.TB Test (T-SPOT) in diagnosing latent tuberculosis infection (LTBI) and guiding isoniazid preventive therapy (IPT) among healthcare professionals (HCP) in tuberculosis (TB)-endemic settings is limited.

    Methods: A prospective study was conducted among Thai HCP undergoing T-SPOT in June 2016 (initial screening) and June 2017 (follow-up). Nine-month isoniazid preventive therapy (IPT) was offered among the HCP with positive T-SPOT. The incidence of TB and the rates of conversion and reversion of T-SPOT were evaluated during the one-year follow-up period (June 2016 to June 2017).

    Results: A total of 140 HCP underwent initial T-SPOT; the median age was 27 years (IQR 25-31 years), 89% were female and 23 (16%) were T-SPOT-positive. Eighty nine HCP (64%) had both initial and follow-up T-SPOTs. Among the 89 HCP, the initial and follow-up rates of T-SPOT positivity were 19% (N = 17) and 24% (N = 21), respectively. The conversion and reversion rates were 10% (N = 9) and 6% (N = 5), respectively. All of the 9 HCP (100%) with T-SPOT conversion reported significant contacts with patients who had active pulmonary TB without using appropriate personal protection equipment. During the 1-year follow-up period, incidence of TB were significantly higher among HCP with T-SPOT conversion compared to HCP with persistent positive T-SPOT, HCP with T-SPOT reversion and HCP with persistent negative T-SPOT [22 vs. 8 vs. 0 vs. 0 cases/100 person-years; P<0.001]. Of the 17 HCP with positive initial T-SPOT, 8 (47%) completed IPT. The incidence of TB was significantly lower and the T-SPOT reversion rate was significantly higher among HCP completing IPT compared to HCP declining or not completing IPT (0 vs. 11 cases/100 person-years; P<0.001 and 63% vs. 0%; P=0.009, respectively).

    Conclusion: T-SPOT could be used for diagnosing LTBI, guiding IPT and identifying HCP with subsequent risk for TB. The serial T-SPOT may be used for evaluating IPT efficacy.

    Thana Khawcharoenporn, M.D., M.Sc.1, Waralee Aksornchindarat, B.Sc.2, Napat Yodpinij, B.Sc.2, Sopa Srisungngam, B.Sc.3, Janisara Rudeeaneksin, B.Sc.3, Supranee Bunchoo, B.Sc.3, Wiphat Klayut, B.Sc.3, Somchai Sangkitporn, M.D.3 and Benjawan Phetsuksiri, Ph.D.3, (1)Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand, (2)Thammasat University, Pathumthani, Thailand, (3)National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand

    Disclosures:

    T. Khawcharoenporn, None

    W. Aksornchindarat, None

    N. Yodpinij, None

    S. Srisungngam, None

    J. Rudeeaneksin, None

    S. Bunchoo, None

    W. Klayut, None

    S. Sangkitporn, None

    B. Phetsuksiri, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.