Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. e1-e5 (doi:10.1542/peds.2006-1057)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Richeldi, L.
Right arrow Articles by Lalvani, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Richeldi, L.
Right arrow Articles by Lalvani, A.
Related Collections
Right arrow Infectious Disease & Immunity
Right arrowRelated AAP Red Book topics:
Tuberculosis
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

EXPERIENCE & REASON

T-Cell–Based Diagnosis of Neonatal Multidrug-Resistant Latent Tuberculosis Infection

Luca Richeldi, MD, PhDa, Katie Ewer, PhDb, Monica Losi, PhDa, Barbara M. Bergamini, MDa, Kerry Millington, BScb,c, Leonardo M. Fabbri, MDa and Ajit Lalvani, FRCP, DMb,c

a Departments of Respiratory Disease and Pediatrics, University of Modena and Reggio Emilia, Modena, Italy
b Tuberculosis Immunology Group, Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
c Tuberculosis Immunology Group, Department of Respiratory Medicine, National Heart and Lung Institute, Wright Fleming Institute of Infection and Immunity, Imperial College London, London, United Kingdom

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.

Key Words: tuberculosis • neonate • diagnosis • ELISpot

Abbreviations: LTBI, latent tuberculosis infection • TST, tuberculin skin test • ELISpot, enzyme-linked immunospot • MDR, multidrug-resistant • PPD, purified protein derivative • ESAT-6, early secretory antigenic target 6 • CFP10, culture filtrate protein 10 • SKSD, streptokinase-streptodornase • SFC, spot-forming cell

Accepted Aug 2, 2006.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 ChestHome page
A. Lalvani
Diagnosing Tuberculosis Infection in the 21st Century: New Tools To Tackle an Old Enemy
Chest, June 1, 2007; 131(6): 1898 - 1906.
[Abstract] [Full Text] [PDF]