Philip Adamo philipad1 at gmail.com
Mon Apr 25 09:50:50 PDT 2016

Hello all
I was part of the study that was quoted——borderline is not negative and not positive and should be repeated in 8-10 weeks. 25% of borderlines go on to be positive. At our facility we do not make a pre-placement candidate wait 8-10 weeks, we obtain a CXR.
Incumbents-as long as they are symptom free, we wait that amount of time. The CDC does not want us to go from one test method to another(IGRA to skin test). 

My experience with this testing has been really good.

Phil Adamo
Baystate Health
> On Apr 25, 2016, at 12:29 PM, Employee Health <employeehealth at gvh.org> wrote:
> <image002.jpg>
> Yes,  had this happen more than once with T-Spot.   Per their website:
>  <>What should I do with a borderline T-SPOT.TB test result?
> Borderline results are clinically interpretable and should be followed. Retesting by collecting another sample is recommended. In a study of U.S. healthcare workers, 23% of subjects with a borderline test result retested as positive, suggesting the borderline category is useful in maintaining test sensitivity. Upon retesting, if the test result remains borderline, other diagnostic tests and/or epidemiologic information should be used to help determine the TB infection status of the patient.1
> 1. King TC, Upfal M, Gottlieb A, et al. T-SPOT.TB Interferon-γ Release Assay Performance in Healthcare Worker Screening at Nineteen U.S. Hospitals. Am J Respir Crit Care Med. 2015;192(3):367-373. doi:10.1164/rccm.201501-0199OC.
> Christy Rossiter, RN, CMSRN
> Employee Health Coordinator
> <image003.jpg>
> 700 Lawn Ave
> Sellersville, PA 18960
> Telephone: 215-453-4016
> Fax: 215-453-4748
> employeehealth at gvh.org <mailto:employeehealth at gvh.org>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net <mailto:mcoh-eh-bounces at mylist.net>] On Behalf Of Senior, Cathy (Employee Health)
> Sent: Monday, April 25, 2016 12:12 PM
> 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 at phhealthcare.org <mailto:cesenior at phhealthcare.org>
> www.phhealthcare.org <http://www.phhealthcare.org/>
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