[MCOH-EH] [External] Re: Quantiferon gold TB test - preplacement question

Spivey, Christine cspivey at CCGH.org
Thu Jul 31 10:26:57 PDT 2014


Would be great if Dr. Thanassi's  talk could be taped and presented as a webinar for those of us that cannot attend.  Hoping someone out there has the ability to make that happen.
Christine

Christine Spivey RN, BSN
Employee Health/ Workers Comp Nurse
Carteret General Hospital
Morehead City, NC 28557
P-252 808-6480
F-252 808-6676
cspivey at ccgh.org



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Thursday, July 31, 2014 1:03 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] [External] Re: Quantiferon gold TB test - preplacement question

Michael, what was the quantitative value of TB-nil? While the lab will call anything over 0.34 positive, there is definitely a grey zone between 0.34 and 1.11 where repeating the test is recommended. If the level is over 1.11 it's likely a true positive. Wendy Thanassi has published a great article on this, attached.

As a teaser, the topic of latent TB infection is one of our MCOH-sponsored sessions at the next AOHP in Baltimore. Wendy will be speaking on interpretation of IGRAs. Allen Kraut, also of this listserv, will add his perspective from the frozen north (aka "Canada") as well :). Plan to attend!

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Band, Michael DO
Sent: Wednesday, July 30, 2014 1:10 PM
To: 'MCOH/EH'
Subject: [External] Re: [MCOH-EH] Quantiferon gold TB test - preplacement question

Sorry

Trying to type between patients.

Yes her quantiferon gold TB test was positive, neg ppd.   I am worried this is a false positive.

Michael Band DO, MS

From: MCOH-EH [mailto:mcoh-eh-bounces+mband=watsonclinic.com at mylist.net] On Behalf Of Morelli, Karen J
Sent: Wednesday, July 30, 2014 2:07 PM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Quantiferon gold TB test - preplacement question

I assume you meant to type that the Quantiferon is positive now after a negative ppd one month ago.  I have been monitoring the Quantiferon issue since we had a cluster of false positives last fall (presumably due to tube/process issues).  The research I have done states that Quantiferon could be run within a 3 day window of receiving a ppd, after that there is a chance of getting a false positive reading on the Quantiferon (from the ppd plant).  There is no concrete "cut off" time frame that I have seen to know when it would be okay to run a Quantiferon after a ppd.  The TB expert in my area stated that false positive Quantiferon tests have been noted up to 6 weeks after a ppd.  Due to the uncertainty of when it would be okay to run a Quantiferon after a ppd, our department has adopted a 6 months cut off time.

Thank you,
Karen Morelli RN, BSN
Eastern Maine Healthcare Systems

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Band, Michael DO
Sent: Wednesday, July 30, 2014 1:41 PM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] Quantiferon gold TB test - preplacement question

Currently we are using the quantiferon gold TB test for use after a positive ppd for preplacement.

Every once in a while a new doctor or employee are not available for a 48-72 hour ppd read so we do quantiferon instead.

Had a new doctor with a negative ppd one month ago at another facility and her quantiferon gold is negative.

NO symptoms of active TB and no known exposures.  She is in a low risk specialty for TB exposure.

Chest xay normal

Question:


1.        I read somewhere that a recent ppd can interfere with the quantiferon gold test.  Not sure if this is true?


2.       What is the next step?  Do we call this latent Tb?  Is it worth repeating the quantiferon gold test?  Could this be a false positive?


Thanks for any help.

Michael Band DO, MS
Watson Clinic

NOTICE OF CONFIDENTIALITY
---------------------------------------------------

The information in this email, including attachments, may be confidential and/or privileged
and may contain confidential health information.
This email is intended to be reviewed only by the individual or organization named as addressee.
If you have received this email in error please notify Watson Clinic immediately
by return message to the sender or to administrator at watsonclinic.com<mailto:administrator at watsonclinic.com>
Destroy all copies of this message and any attachments.
Please note that any views or opinions presented in this email are solely those of the author
and do not necessarily represent those of Watson Clinic.
Confidential health information is protected by state and federal law, including, but not limited to:
The Health Insurance Portability and Accountability Act of 1996 and related regulations.
-------------------------------------------------------------------------------------------------------------------
This email message, including any associated files, is for the sole use of the intended recipient(s) and may contain information that is confidential, privileged, or subject to copyright, trade secret or other protection. This message also may contain information protected by state and federal privacy laws that are enforced through serious civil and criminal sanctions. Any unauthorized review, use, disclosure, or distribution is prohibited. If you are not an intended recipient of this message, please notify the sender immediately by replying to this e-mail, and delete the original and all copies of this message from your computer or other device.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mylist.net/archives/mcoh-eh/attachments/20140731/9cc6644f/attachment.html>


More information about the MCOH-EH mailing list