Diagnosis of Mycobacterium tuberculosisT

hese tests diagnose TB-infected persons who are at increased risk for TB development and
who will benefit from treatment. The QuantiFERON-TB test (QFT-G) is a new test used to
detect latent TB. The QFT-G measures interferon- (IFN- ), a component of cell-mediated
immune activity to TB response. Tuberculin skin testing (TST) screens for new or latent TB
infection in high-risk groups. The TST measures lymphocyte response to TB in persons
sensitized to the TB antigen. This test has been used for years and measures a delayed
hypersensitivity response (48 to 72 hours).
Reference Values
Normal
QuantiFERON-TB Gold Test (QFT-G):
Negative: < 0.35 IU/mL IFN-y
Positive: ≥ 0.35 IU/mL IFN-y
Tuberculin skin testing (TST): negative for cutaneous hypersensitivity—area of induration,
<10 mm
Procedure
1. Obtain a 5-mL venous blood sample (dark-green topped [sodium heparin] tube) for
the QFT-G.
2. See description in Tuberculin Skin Test section.
Clinical Implication
1. A positive QFT-G result indicates that TB infection is likely.
2. A negative QFT-G result indicates that TB infection is unlikely but cannot be
excluded

Interfering Factors
1. Diabetes, silicosis, and chronic renal failure may decrease responsiveness to both the
TST and QFT-G tests.
2. Treatment with immunosuppressive drugs has been shown to decrease the response to
the TST.
3. Some of the hematologic disorders, such as leukemia and lymphoma, may decrease
response to the TST and QFT-G test.

Interventions
Pretest Patient Care
1. Explain test purpose and blood-drawing procedure.
2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

1. Interpret test results and counsel appropriately.
2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care