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T-cell-based diagnosis of neonatal multidrug-resistant latent tuberculosis infection

T-cell-based diagnosis of neonatal multidrug-resistant latent tuberculosis infection
T-cell-based diagnosis of neonatal multidrug-resistant latent tuberculosis infection
Young children exposed to tuberculosis have a high risk of progression to severe tuberculosis disease, but diagnosis of recent infection is hindered by the poor sensitivity of the tuberculin skin test. Whether new blood tests can detect latent infection in this vulnerable group is unknown because there is no gold standard. We monitored a tuberculin skin test-negative infant whose mother had infectious multidrug-resistant tuberculosis with enzyme-linked immunospot, a blood test that enumerates Mycobacterium tuberculosis-specific T cells. The enzyme-linked immunospot test became persistently positive by 6 months, and 18 months later the child developed active tuberculosis despite appropriate chemoprophylaxis. At this point, the magnitude of the enzyme-linked immunospot response increased >10-fold. Our findings demonstrate that this blood test detected latent infection with dormant, yet viable, bacilli and illustrate how enzyme-linked immunospot could improve diagnosis of childhood tuberculosis infection.
tuberculosis, neonate, diagnosis, ELISpot
0031-4005
e1-e5
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Ewer, Katie
7492f401-c61a-4b20-b8d9-adfa7b39c11a
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Bergamini, Barbara M.
7e2a006a-e3af-48a4-a47d-4a73f6fd6275
Millington, Kerry
d24af203-b126-472e-a35a-a0af8fb2fb92
Fabbri, Leonardo M.
0f4844a3-b97f-4c2d-9414-bd8d5bd383b7
Lalvani, Ajit
ac754f14-ec6b-4a5b-8a72-6bb1e114b626
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Ewer, Katie
7492f401-c61a-4b20-b8d9-adfa7b39c11a
Losi, Monica
6f2acb9f-04c8-45fc-9921-7b0a0f439129
Bergamini, Barbara M.
7e2a006a-e3af-48a4-a47d-4a73f6fd6275
Millington, Kerry
d24af203-b126-472e-a35a-a0af8fb2fb92
Fabbri, Leonardo M.
0f4844a3-b97f-4c2d-9414-bd8d5bd383b7
Lalvani, Ajit
ac754f14-ec6b-4a5b-8a72-6bb1e114b626

Richeldi, Luca, Ewer, Katie, Losi, Monica, Bergamini, Barbara M., Millington, Kerry, Fabbri, Leonardo M. and Lalvani, Ajit (2007) T-cell-based diagnosis of neonatal multidrug-resistant latent tuberculosis infection. Pediatrics, 119 (1), e1-e5. (doi:10.1542/peds.2006-1057). (PMID:17200234)

Record type: Article

Abstract

Young children exposed to tuberculosis have a high risk of progression to severe tuberculosis disease, but diagnosis of recent infection is hindered by the poor sensitivity of the tuberculin skin test. Whether new blood tests can detect latent infection in this vulnerable group is unknown because there is no gold standard. We monitored a tuberculin skin test-negative infant whose mother had infectious multidrug-resistant tuberculosis with enzyme-linked immunospot, a blood test that enumerates Mycobacterium tuberculosis-specific T cells. The enzyme-linked immunospot test became persistently positive by 6 months, and 18 months later the child developed active tuberculosis despite appropriate chemoprophylaxis. At this point, the magnitude of the enzyme-linked immunospot response increased >10-fold. Our findings demonstrate that this blood test detected latent infection with dormant, yet viable, bacilli and illustrate how enzyme-linked immunospot could improve diagnosis of childhood tuberculosis infection.

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More information

Published date: January 2007
Keywords: tuberculosis, neonate, diagnosis, ELISpot
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 368972
URI: https://eprints.soton.ac.uk/id/eprint/368972
ISSN: 0031-4005
PURE UUID: 9223e67a-83c0-4394-947c-c1bdcee79ce4

Catalogue record

Date deposited: 10 Oct 2014 14:06
Last modified: 18 Jul 2017 01:41

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