A Targeted Screening Program for Latent Tuberculosis Infection Among Hematopoietic Cell Transplant Recipients.
QuantiFERON
cancer
hematopoietic cell transplant
screening
tuberculosis
Journal
Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
09
01
2020
accepted:
05
06
2020
entrez:
17
7
2020
pubmed:
17
7
2020
medline:
17
7
2020
Statut:
epublish
Résumé
US hematopoietic cell transplantation (HCT) recipients have a low prevalence of latent tuberculosis infection (LTBI), but if latently infected they are at risk for progression to active tuberculosis. At our center, all HCT recipients underwent LTBI testing pretransplant by tuberculin skin testing (TST) until 2013 when we implemented a targeted screening program. Our objective was to assess the utility of our screening program that incorporated a pretransplant LTBI questionnaire to target TST and QuantiFERON TB Gold (QFT) testing. We performed a retrospective cohort study of HCT recipients undergoing first transplant from 2014 to 2016. Patients with positive, indeterminate, and a subset with negative QFT results underwent electronic medical record (EMR) review to assess TST results and risk factors for LTBI. Among 1290 eligible recipients, 457 (35%) had at least 1 risk factor for LTBI on the pretransplant questionnaire; nonwhites were more likely to undergo LTBI testing ( Incorporating a pretransplant LTBI questionnaire allowed for an approximate 65% reduction in LTBI testing when compared with universal testing among this low prevalence population.
Sections du résumé
BACKGROUND
BACKGROUND
US hematopoietic cell transplantation (HCT) recipients have a low prevalence of latent tuberculosis infection (LTBI), but if latently infected they are at risk for progression to active tuberculosis. At our center, all HCT recipients underwent LTBI testing pretransplant by tuberculin skin testing (TST) until 2013 when we implemented a targeted screening program. Our objective was to assess the utility of our screening program that incorporated a pretransplant LTBI questionnaire to target TST and QuantiFERON TB Gold (QFT) testing.
METHODS
METHODS
We performed a retrospective cohort study of HCT recipients undergoing first transplant from 2014 to 2016. Patients with positive, indeterminate, and a subset with negative QFT results underwent electronic medical record (EMR) review to assess TST results and risk factors for LTBI.
RESULTS
RESULTS
Among 1290 eligible recipients, 457 (35%) had at least 1 risk factor for LTBI on the pretransplant questionnaire; nonwhites were more likely to undergo LTBI testing (
CONCLUSIONS
CONCLUSIONS
Incorporating a pretransplant LTBI questionnaire allowed for an approximate 65% reduction in LTBI testing when compared with universal testing among this low prevalence population.
Identifiants
pubmed: 32671130
doi: 10.1093/ofid/ofaa224
pii: ofaa224
pmc: PMC7348235
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ofaa224Subventions
Organisme : NCI NIH HHS
ID : P30 CA015704
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Références
Bone Marrow Transplant. 1997 Mar;19(5):467-70
pubmed: 9052913
Eur Respir J. 2007 Jun;29(6):1212-6
pubmed: 17215314
Front Immunol. 2017 Nov 09;8:1506
pubmed: 29170666
Clin Infect Dis. 2019 Aug 16;69(5):869-872
pubmed: 30689792
PLoS One. 2017 Mar 9;12(3):e0173250
pubmed: 28278166
Eur Respir J. 2017 Aug 24;50(2):
pubmed: 28838977
Clin Microbiol Infect. 2004 Aug;10(8):749-52
pubmed: 15301678
Clin Transplant. 2018 Dec;32(12):e13430
pubmed: 30347465
Int J Tuberc Lung Dis. 2007 Jul;11(7):788-91
pubmed: 17609055
Annu Rev Immunol. 2013;31:475-527
pubmed: 23516984
BMJ Open. 2018 Sep 12;8(9):e022445
pubmed: 30209157
Cold Spring Harb Perspect Med. 2015 Aug 20;6(2):a018192
pubmed: 26292985
Biol Blood Marrow Transplant. 2009 Oct;15(10):1143-238
pubmed: 19747629
Int J Mycobacteriol. 2016 Jun;5(2):177-84
pubmed: 27242229
Tuberc Respir Dis (Seoul). 2018 Jan;81(1):6-12
pubmed: 29332319
PLoS One. 2017 Nov 2;12(11):e0187313
pubmed: 29095918
Transpl Infect Dis. 2018 Aug;20(4):e12912
pubmed: 29679523
N Engl J Med. 2011 Apr 14;364(15):1441-8
pubmed: 21488766
Am J Respir Crit Care Med. 2000 Apr;161(4 Pt 2):S221-47
pubmed: 10764341
Thorax. 2005 Oct;60(10):800-5
pubmed: 16055611
PLoS One. 2009 Dec 30;4(12):e8517
pubmed: 20041113
Arthritis Rheumatol. 2016 Jan;68(1):1-26
pubmed: 26545940
Eur Respir J. 2015 Dec;46(6):1563-76
pubmed: 26405286
Kekkaku. 2014 Feb;89(2):77-88
pubmed: 24716362
J Clin Microbiol. 2012 Sep;50(9):3105-7
pubmed: 22785197
Clin Microbiol Rev. 2014 Jan;27(1):3-20
pubmed: 24396134
Ann Intern Med. 2007 Mar 6;146(5):340-54
pubmed: 17339619
Chest. 2009 Jul;136(1):198-204
pubmed: 19318676
Lung Cancer. 2014 Sep;85(3):472-8
pubmed: 25063540
Eur Respir J. 2010 May;35(5):1179-82
pubmed: 20436175
South Asian J Cancer. 2012 Jul;1(1):36-42
pubmed: 24455507
Eur Respir J. 2012 Oct;40(4):990-1013
pubmed: 22496318