Pros and Cons of Newer, Faster T.B. Tests Now in U.S. Hospitals

Nationwide shortages of PPD solution are still being reported, prompting state departments of health to recommend alternative testing.

Nationwide shortages of PPD solution are still being reported, prompting state departments of health to recommend alternative testing. If PPD tests can’t be found, the Center for Disease Control recommends an IGRA blood test; it may require a blood draw, but presents distinct advantages, especially for international patients, who have had the Bacille Calmette Guerin (tuberculin test), used outside the United States.

Because the traditional PPD is, of late, harder to come by, more registered nurses are satisfying the annual requirement of a TB test with the Interferon-Gamma Release Assays (IGRA).  Many healthcare employers are using IGRA test brands, approved by the FDA: QuantiFERON®-TB Gold In-Tube test (QFT-GIT) and T-SPOT®.  These new tests save nursing staff the extra hassle of a two-step TB; however, travel nurses should always check with their agency to be sure that the pending healthcare employer accepts IGRAs, as some are not yet accepting this relatively new test. If healthcare employers do offer the IGRA, travel nurses need to make sure that the blood draw required can be analyzed within 12 hours of giving the specimen. RNs are encouraged to check with a staffing consultant for guidance on this matter, as American Traveler continues to work closely with hospital clients to understand and meet specific needs.

Registered Nurses’ Pros Regarding IGRAs

Notable advantages to Quantiferon Gold include the absence of false positive test results that run as high as 20 to 30% in traditional PPD tests. The IRA blood test does not boost responses measured by subsequent tests—a factor that gets persons with TB diagnosed and into treatment, with the hope of reducing the statistic of 1.7 million deaths (from tuberculosis) each year**. A positive IGRA result may not indicate active TB; however a negative IGRA rules out the possibility of both active and latent tuberculosis.

“Cons” to the IGRA Test   

Samples must be processed while white blood cells are still viable—and that requires finesse from the healthcare professional conducting the test. Any errors in collecting or transporting can decrease the accuracy of IGRAs. At present, data on the use of IGRAs that predicts who will progress to TB disease in the future is limited, as is data collected from testing youths under age 5. For healthcare staff and patients who prefer the traditional tuberculin skin test, there are the FDA approved Tubersol (Sanofi Pasteur Limited) and Aplisol (JHP Pharmaceuticals, LLC).

R.N.s Worldwide Agree: “Whatever the conditions of people's lives, wherever they live, however they live, we all share the same dreams."  Melinda Gates

The NIH and Bill and Melinda Gates Foundation funded research to find a test that was quick, able to screen for multi-drug resistance and automated to limit human error. With early diagnosis and careful management and follow up, TB is something that can be divinely conquered, as seen in the inspiring video below: "A Door-by-Door approach to fighting tuberculosis" that will make R.N.s who work with afflicted patients feel incredibly good about what they do!

Friday March 07, 2014

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