Document Detail

T-cell-based diagnosis of neonatal multidrug-resistant latent tuberculosis infection.
MedLine Citation:
PMID:  17200234     Owner:  NLM     Status:  MEDLINE    
Young children exposed to tuberculosis have a high risk of progression to severe tuberculosis disease, but diagnosis of recent infection is hindered by the poor sensitivity of the tuberculin skin test. Whether new blood tests can detect latent infection in this vulnerable group is unknown because there is no gold standard. We monitored a tuberculin skin test-negative infant whose mother had infectious multidrug-resistant tuberculosis with enzyme-linked immunospot, a blood test that enumerates Mycobacterium tuberculosis-specific T cells. The enzyme-linked immunospot test became persistently positive by 6 months, and 18 months later the child developed active tuberculosis despite appropriate chemoprophylaxis. At this point, the magnitude of the enzyme-linked immunospot response increased >10-fold. Our findings demonstrate that this blood test detected latent infection with dormant, yet viable, bacilli and illustrate how enzyme-linked immunospot could improve diagnosis of childhood tuberculosis infection.
Luca Richeldi; Katie Ewer; Monica Losi; Barbara M Bergamini; Kerry Millington; Leonardo M Fabbri; Ajit Lalvani
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  119     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-03     Completed Date:  2007-01-30     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1-5     Citation Subset:  AIM; IM    
Department of Respiratory Disease, University of Modena and Reggio Emilia, Modena, Italy.
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MeSH Terms
Antigens, Bacterial / immunology*
Antitubercular Agents / therapeutic use
DNA Fingerprinting
Enzyme-Linked Immunosorbent Assay*
Infant, Newborn
Interferon-gamma / biosynthesis*
Mycobacterium tuberculosis / classification,  immunology*
Polymorphism, Restriction Fragment Length
Pregnancy Complications, Infectious / diagnosis,  drug therapy
T-Lymphocytes / immunology*
Tuberculin Test
Tuberculosis, Multidrug-Resistant / congenital*,  diagnosis*,  prevention & control
Grant Support
//Wellcome Trust
Reg. No./Substance:
0/Antigens, Bacterial; 0/Antitubercular Agents; 82115-62-6/Interferon-gamma

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