Discordance among commercially available diagnostics for latent tuberculosis infection

James D. Mancuso*, Gerald H. Mazurek, David Tribble, Cara Olsen, Naomi E. Aronson, Lawrence Geiter, Donald Goodwin, Lisa W. Keep

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Rationale: There is uncertainty regarding how to interpret discordance between tests for latent tuberculosis infection. Objectives: The objective of this study was to assess discordance between commercially available tests for latent tuberculosis in a low-prevalence population, including the impact of nontuberculous mycobacteria. Methods: This was a cross-sectional comparison study among 2,017 military recruits at Fort Jackson, South Carolina, from April to June 2009. Several tests were performed simultaneously with a risk factor questionnaire, including (1) QuantiFERON-TB Gold In-Tube test, (2) T-SPOT.TB test, (3) tuberculin skin test, and (4) Battey skin test using purified protein derivative from the Battey bacillus. Measurements and Main Results: In this low-prevalence population, the specificities of the three commercially available diagnostic tests were not significantly different. Of the 88 subjects with a positive test, only 10 (11.4%) were positive to all three tests; 20 (22.7%) were positive to at least two tests. Bacille Calmette-Guérin vaccination, tuberculosis prevalence in country of birth, and Battey skin test reaction size were associated with tuberculin skin test-positive, IFN-γ release assay-negative test discordance. Increasing agreement between the three tests was associated with epidemiologic criteria indicating risk of infection and with quantitative test results.

Original languageEnglish
Pages (from-to)427-434
Number of pages8
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number4
StatePublished - 15 Feb 2012
Externally publishedYes


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