Thanks Melanie for your response.
I heard Wendy at an AHOP conference
last year.
We do not use QFT as an alternate to
TSPOT.
We use one methodology and we stick
too it.
This means that we do less retesting.
We only retest borderline or invalid
TSPOTS not all positive TSPOTS.
Our lab does not draw them the TSPOTS
for our employee population, only my clinic staff.... about 6,000 to 7,000
a year.
Thanks,
Kathy Dayvault, RN, BSN, MPH, COHN-S/CM
Manager, Occupational Health and
Safety
WorksWell Onsite
Dekalb Medical 2701 North
Decatur Road
Decatur, GA 30033
ph: 404.501.4972 Fax:404-501-2045
kathy.dayvault@dekalbmedical.org
From:
"Swift, Melanie"
<melanie.swift@Vanderbilt.Edu>
To:
MCOH/EH <mcoh-eh@mylist.net>,
Date:
04/25/2016 12:59 PM
Subject:
Re: [MCOH-EH]
IGRA
Sent by:
"MCOH-EH"
<mcoh-eh-bounces@mylist.net>
Cathy,
By your use of the term “borderline”
I’m guessing you use T-Spot. But in case you were using it in a more generic
sense, there is a good article by Wendy Thanassi et al delineating a retesting
zone for QFT-GIT using the 0.35 – 1.11 IU/ml results. Wendy spoke at our
AOHC a couple of weeks ago and shared a helpful algorithm using 1.1 as
the cutoff for the first test and 0.7 as the cutoff for the retest. Again,
that probably won’t help you much if you are using T-spot.
The CDC lists this situation
as a time when you might want to do both a TST and an IGRA. If the TST
is negative and the person is low risk and the IGRA remains borderline,
it’s less like to be an LTBI case than if the TST is positive also.
You really should sit down
with your medical director and develop a protocol based on the quantitative
result, and the specific IGRA you use (T-Spot or QTF-GIT.) Hopefully he
or she participates on this listserve also!
Here are some references
that may be helpful in writing your protocol:
http://www.hindawi.com/journals/pm/2012/291294/
https://labmed.oxfordjournals.org/content/45/3/207
http://www.atsjournals.org/doi/abs/10.1164/rccm.201305-0831OC
Melanie Swift, MD
Director, Vanderbilt Occupational
Health Clinic
http://occupationalhealth.vanderbilt.edu
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net]
On Behalf Of Senior, Cathy (Employee Health)
Sent: Monday, April 25, 2016 11:12 AM
To: 'MCOH/EH'
Subject: [MCOH-EH] IGRA
We use Interferon Gamma
Release Assays ( IGRA) to test for tuberculosis on all new employees. I
have one new employee that I have tested twice (with approx one month in
between testing) and both times the results were borderline. Has
anyone else had this come up and if so what did you do next? This
employee has no symptoms and no high risk activity such as traveling outside
the country or having contact with anyone with known Tb.
Cathy Senior RN BSN
CDE
Employee Health Director
Penn Highlands DuBois
100 Hospital Avenue
P.O. Box 447
DuBois Pa 15801
Phone 814-375-3392
Fax 814-372-2610
cesenior@phhealthcare.org
www.phhealthcare.org
This email and any attached files are
sensitive in nature and intended solely for the intended recipient(s).
If you are not the named recipient you should not read, distribute, copy
or alter this email. Any views or opinions expressed in this email are
those of the author and do not represent those of Penn Highlands Healthcare
or its affiliates.. Warning: Although precautions have been taken to make
sure no viruses are present in this email, the company cannot accept responsibility
for any loss or damage that arise from the use of this email or attachments.---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh@mylist.net
To become a subscriber, or to change your subscription options (turn off
email while you're on vacation, etc): http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support
to ensure the list remains a free resource for the occupational health
community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe@meditrax.com
---------------------------------------
CONFIDENTIALITY NOTICE: This e-mail, including attachments, is for the sole use of the individual(s) to whom it is addressed, and may contain confidential and privileged information, including HIPAA protected PHI. Any unauthorized review, use, disclosure, distribution, or reproduction is prohibited. If you have received this e-mail in error, please notify the sender by reply e-mail and destroy this message and its attachments in its entirety.