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Preemployment Screening for Tuberculosis in a Large Health Care Setting: Comparison of the Tuberculin Skin Test and a Whole-Blood Interferon-γ Release Assay

Khoury, Nicole Zitterkopf PhD; Binnicker, Matthew J. PhD; Wengenack, Nancy L. PhD; Aksamit, Timothy R. MD; Buchta, William G. MD; Molella, Robin G. MD

Journal of Occupational and Environmental Medicine: March 2011 - Volume 53 - Issue 3 - p 290–293
doi: 10.1097/JOM.0b013e31820c91c5
Original Articles

Objective: Determine the performance of an interferon-γ release assay in a health care occupational surveillance program.

Methods: From January 11, 2005, through January 31, 2006, all new employees (n = 652) undergoing standard, preemployment evaluation at Mayo Clinic, Rochester, Minnesota were evaluated for tuberculosis using a standard process of symptom screening combined with tuberculin skin test (TST) and QuantiFERON-TB Gold test (QFT-G).

Results: Comparing the results of QFT-G directly to TST, QFT-G showed an overall agreement of 92.5%.

Conclusions: False-positive TST were the most significant issue affecting agreement, and in a low–tuberculosis prevalence population, the need for an effective strategy offering low false-positive results may be best met by combining the TST with QFT-G.

From the Oklahoma State Department of Health Public Health Laboratory (Dr Khoury), Oklahoma City, Ok; Division of Clinical Microbiology (Drs Binnicker and Wengenack), Division of Pulmonary and Critical Care Medicine (Dr Aksamit), Division of Preventive, Occupational and Aerospace Medicine (Drs Buchta and Molella), Mayo Clinic, Rochester, Minn.

Address Correspondence to: Robin G. Molella, MD, Mayo Clinic, 200 1st St SW, Rochester, MN 55905; E-mail:

©2011The American College of Occupational and Environmental Medicine