重组结核杆菌融合蛋白在肺结核密切接触者中筛查结核分枝杆菌感染效果分析OA北大核心CSTPCD

Objective:To evaluate the accuracy and feasibility of recombinant Mycobacterium tuberculosis fusion protein(EC)skin test in tuberculosis screening among close contacts of pulmonary tuberculosis patients and to provide technical recommendations for improving tuberculosis control,and to understand the status of latent infection of Mycobacterium tuberculosis(LTBI)in close contacts.Methods:A total of 140 close contacts of tuberculosis patients from Fengxian and Jinshan Districts in Shanghai City were selected as the study subjects.Both IGRA and EC skin tests were administered.Kappa test was used to assess the consistency between the results of those two methods,and chi-square test was employed to compare the differences between these two detection methods.A P-value of＜0.05 was considered statistically significant.Results:A total of 140 subjects were included in the study,consisting of 55 males and 85 females.The positive rate of IGRA was 15.00％(21/140),while the positive rate of EC skin test was 14.29％(20/140).There was no statistically significant difference between them(x2=0.029,P=0.866),with a Kappa value of 0.857(P=0.001),indicating a high degree of consistency.When IGRA was used as the reference standard for tuberculosis infection,EC skin test demonstrated a sensitivity of 85.71％(18/21),a specificity of 98.32％(117/119),a positive predictive value of 90.00％(18/20),and a negative predictive value of 97.50％(117/120).The positive rate of EC in males(32.73％,18/55)was significantly higher than that in females(2.35％,2/85),and the difference was statistically significant(x2=17.983,P＜0.001).Conclusion:EC skin test demonstrates high specificity and can be utilized for Mycobacterium tuberculosis infection screening among close contacts of tuberculosis patients.However,due to limitations regarding age range and contraindications for use,implementing a combined screening method of EC and IGRA is advisable.