[MCOH-EH] IGRA
Kathy.Dayvault at dekalbmedical.org
Kathy.Dayvault at dekalbmedical.org
Mon Apr 25 10:03:12 PDT 2016
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 at dekalbmedical.org
From: "Swift, Melanie" <melanie.swift at Vanderbilt.Edu>
To: MCOH/EH <mcoh-eh at mylist.net>,
Date: 04/25/2016 12:59 PM
Subject: Re: [MCOH-EH] IGRA
Sent by: "MCOH-EH" <mcoh-eh-bounces at 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 at 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 at 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 at 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 at 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.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mylist.net/archives/mcoh-eh/attachments/20160425/e37b28ca/attachment.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: not available
Type: image/jpeg
Size: 959 bytes
Desc: not available
URL: <http://mylist.net/archives/mcoh-eh/attachments/20160425/e37b28ca/attachment.jpe>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Dayvault_Kathy.vcf
Type: application/octet-stream
Size: 435 bytes
Desc: not available
URL: <http://mylist.net/archives/mcoh-eh/attachments/20160425/e37b28ca/attachment.obj>
More information about the MCOH-EH
mailing list