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Tuberculosis blood testing for your employees

Tuberculosis (TB) is one of the leading causes of infectious disease morbidity and mortality worldwide1 and is an ongoing concern for employers managing the health of their employees. With reported incidence of tuberculosis rising 9.4% in 2021,2 hospitals and healthcare systems must recommit themselves to focus on TB prevention and control strategies to help protect their staff and local communities from TB disease.

TB screening and testing for healthcare workers:
current CDC recommendations3

Pre-employment and post-exposure TB testing of staff is crucial to help stop the spread of TB and keep employees and communities safe. The CDC recommends TB screening and testing of all US healthcare personnel upon hire as part of a TB Infection Control Plan.

Pre-employment screening and testing3

  • Baseline individual TB risk assessment
  • TB symptom evaluation
  • A TB blood test

When to test during employment

Annual testing is not required unless there is a known TB exposure or outbreak3

Annual TB education

Healthcare personnel should receive TB education every year3

Testing requirements may vary

Some states may have different regulations— always follow your state’s guidance3

Post-exposure screening and testing3

All healthcare personnel with a known TB exposure should receive a TB symptom evaluation and timely testing, if indicated

 

Healthcare personnel with a previous negative TB test result should be tested immediately and retested 8-10 weeks after exposure

 

For consistency, the same type of TB test should be used for pre-employment testing and for any follow-up testing

 

Healthcare personnel with a previous positive TB test result do not need to be retested after TB exposure

 

 

How to structure your TB testing program

Optimize TB blood testing for your employee and occupational health initiatives
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Blood versus skin testing

Traditional tuberculin skin tests (TSTs) are over a century old and feature some drawbacks from newer blood testing options, such as interferon-gamma release assays (IGRAs), that are more convenient, reliable,4 and effective5 for TB testing.

Accurate.6,7 Accessible. Efficient—TB blood testing from Quest Diagnostics

Quest Diagnostics is the only laboratory with 2 IGRA blood tests approved for use by the FDA: the QuantiFERON®-TB Gold Plus and T-SPOT®.TB.a With either assay, only a single patient visit is required for a blood draw. Results are not subject to reader interpretation nor are they affected by BCG-vaccination, providing a simpler, more effective process of TB testing as compared to TST tests.

a Quest Diagnostics has validated the use of this assay under CLIA for processing specimens more than 8 hours after collection, up to 54 hours.

  • 97.1% specificity [95% CI 94.5%-98.7%] in a US low-risk population7
  • 95.6% sensitivity [95% CI 91.6%-98.1%] in culture-confirmed populations7
  • Flexible collection option: 1 tube
  • Results available from a single patient visit
  • Results reported straight into EHR
  • Approved for immunocompromised patients
T-SPOT®.TB detailed information

  • Innovative CD4+ and CD8+ T-cell technology delivers a more comprehensive evaluation of patients’ immune response to TB
  • >97% specificity and >94% sensitivity6
  • Flexible collection options: 4 tubes or 1 tube
  • Results available from a single patient visit
  • Results reported straight into EHR
QuantiFERON®-TB Gold Plus detailed information

The T-SPOT®.TB test is an in vitro diagnostic test for the detection of effector T cells that respond to stimulation by Mycobacterium tuberculosis antigens ESAT-6 and CFP-10 by capturing interferon gamma (IFN-γ) in the vicinity of T cells in human whole blood collected in sodium citrate or sodium or lithium heparin. It is intended for use as an aid in the diagnosis of M tuberculosis infection. The T-SPOT.TB test is an indirect test for M tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations.

 

Up-to-date relevant warnings, precautions, side effects, and contraindications can be found at: http://www.oxfordimmunotec.com/north-america/

 

QuantiFERON®-TB Gold Plus. This test is a blood-based interferon-gamma release assay (IGRA) used as an aid in the diagnosis of Mycobacterium tuberculosis infection. It is an immune response-based, indirect test for M tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations. Additional testing is needed to determine if a person who has tested positive has latent tuberculosis (TB) infection or TB disease.

 

This in vitro diagnostic test uses a peptide cocktail simulating ESAT-6, CFP-10, and TB7.7 proteins to stimulate cells in heparinized whole blood. Detection of interferon-γ (IFN-γ) by ELISA is used to identify in vitro responses to those peptide antigens that are associated with Mycobacterium tuberculosis infection.

 

References

1. CDC. Tuberculosis. Updated April 6, 2020. Accessed August 25, 2022. https://www.cdc.gov/globalhealth/newsroom/topics/tb/index.html

2. Filardo TD, Feng P, Pratt RH, et al. Tuberculosis — United States, 2021. MMWR Morb Mortal Wkly Rep. 2022;71(12):441–446. doi:10.15585/mmwr.mm7112a1

3. CDC. TB screening and testing of health care personnel. Updated August 30, 2022. Accessed August 29, 2022. https://www.cdc.gov/tb/topic/testing/healthcareworkers.htm

4. CDC. Tuberculin skin testing fact sheet. Updated November 2, 2020. Accessed August 29, 2022. https://www.cdc.gov/tb/publications/factsheets/testing/skintesting.htm

5. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017;64(2):111-115. doi:10.1093/cid/ciw778

6. Qiagen. TB testing with QFT-Plus. Accessed August 29, 2022. https://www.qiagen.com/us/applications/tb-management/products

7. T-SPOT®.TB. Package Insert. Oxford Immunotec; 2021. Accessed August 29, 2022. https://www.tspot.com/wp-content/uploads/2021/04/TB-PI-US-0001-V9.pdf

Optimize TB testing for your employee and occupational health initiatives

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