We do the same, but treat the borderline like we would as a post exposure, retesting in 10 weeks for annual testing.

Also, it helps to draw two tubes on the second dray...I can't explain, but that often gives us a result

If it remains borderline, we send them for evaluation

If the person is a new hire, we have to retest immediately, draw two tubes.

If we continue to get a borderline result, they are sent for evaluation, either our board of health TB unit or an Id physician.

New hires are responsible for the cost, we assume the cost for the annuals.

They must be cleared before they can attend new hire orientation.


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

From:        Employee Health <employeehealth@gvh.org>
To:        MCOH/EH <mcoh-eh@mylist.net>,
Date:        04/25/2016 12:30 PM
Subject:        Re: [MCOH-EH] IGRA
Sent by:        "MCOH-EH" <mcoh-eh-bounces@mylist.net>

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- 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
700 Lawn Ave
Sellersville, PA 18960
Telephone: 215-453-4016
Fax: 215-453-4748
From: MCOH-EH [mailto:mcoh-eh-bounces@mylist.net] On Behalf Of Senior, Cathy (Employee Health)
Monday, April 25, 2016 12:12 PM

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
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