Skin test reactions to Mycobacterium tuberculosis purified protein derivative and Mycobacterium avium sensitin among health care workers and medical students in the United States.

Abstract

SETTING:

Health care workers and medical students in the United States subject to annual tuberculin skin testing.

OBJECTIVE:

To use skin testing with Mycobacterium avium sensitin (MAS) to determine contemporary rates of infection with non-tuberculous mycobacteria (NTM) and their effect on reactions to M. tuberculosis purified protein derivative (PPD).

DESIGN:

Dual skin testing was performed with PPD and MAS on 784 health care workers and medical students in the northern and southern US. MAS reactions that were > or = 5 mm and also > or = 3 mm larger than the PPD reaction were defined as MAS dominant and due to NTM.

RESULTS:

MAS reactions were > or = 5 mm in 40% and > or = 15 mm in 18% of subjects; 95% were MAS dominant. MAS dominant reactions were more common in the south than the north (P < 0.001). PPD reactions were > or = 15 mm in 3% of subjects. PPD reactions > or = 15 mm were more common among males, foreign born subjects and subjects with BCG immunization (all P < 0.001). MAS dominant reactions were found in 82% of subjects with 5-9 mm PPD reactions and 50% with 10-14 mm PPD reactions; these reactions were more common among whites (P = 0.046), US-born (P = 0.038) and subjects without BCG immunization (P = 0.004).

CONCLUSIONS:

Infections with NTM are responsible for the majority of 5-14 mm PPD reactions among US-born health care workers and medical students subject to annual tuberculin testing.

• Authors: C F von Reyn, C R Horsburgh, K N Olivier, P F Barnes, R Waddell, C Warren, S Tvaroha, A S Jaeger, A D Lein, L N Alexander, D J Weber, A N Tosteson
• Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 5 Issue 12 Pg. 1122-8 (Dec 2001) ISSN: 1027-3719 [Print] France
• PMID: 11769770 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antigens
• Tuberculin
• sensitin

Topics

• Adult
• Aged
• Antigens
• Female
• Health Personnel (statistics & numerical data)
• Humans
• Male
• Middle Aged
• Mycobacterium avium Complex (immunology)
• Mycobacterium tuberculosis (immunology)
• Prevalence
• Reference Values
• Students, Medical (statistics & numerical data)
• Tuberculin
• Tuberculin Test (methods)
• Tuberculosis (diagnosis, epidemiology, immunology)
• United States (epidemiology)