• Tuberculosis and Respiratory Diseases
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• v.76 no.6
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• pp.261-268
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• 2014

Patients with immune-mediated inflammatory diseases (IMIDs) are increasingly being treated with anti-tumor necrosis factor (TNF) agents and are at increased risk of developing tuberculosis (TB). Therefore, diagnosis and treatment of latent TB infection (LTBI) is recommended in these patients due to the initiation of anti-TNF therapy. Traditionally, LTBI has been diagnosed on the basis of clinical factors and a tuberculin skin test. Recently, interferon-gamma releasing assays (IGRAs) that can detect TB infection have become available. Considering the high-risk of developing TB in patients on anti-TNF therapy, the use of both a tuberculin skin test and an IGRA should be considered to detect and treat LTBI in patients with IMIDs. The traditional LTBI treatment regimen consisted of isoniazid monotherapy for 9 months. However, shorter regimens such as 4 months of rifampicin or 3 months of isoniazid/rifampicin are increasingly being used to improve treatment completion rates. In this review, the screening methods for diagnosing latent and active TB before anti-TNF therapy in patients with IMIDs will be briefly described, as well as the current LTBI treatment regimens, the recommendations for managing TB that develops during anti-TNF therapy, the necessity of regular monitoring to detect new TB infection, and the re-initiation of anti-TNF therapy in patients who develop TB.

• The Journal of the Korean Society for Microbiology
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• v.5 no.1
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• pp.41-48
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• 1970

In order to assay one lot of the potency of tuberculin for intradermic use, four guinea pigs sensitized with heat killed M. tuberculosis were used by the method originally of the Agriculture Research Service Center(A. R. S.) and Bureau of Animal. Industry(B. A. I.) in the United. States of America in which guinea pigs were used on 21st day after sensitization. There is doubt whether the guinea pigs are sensitized or not. Therefore, this study has taken the method of Middle Brook-Dubos hemagglutination test, and observed the humoral hemagglutinating antibody in the blood. The results obtained are as follows. 1. The maximum titer of hemagglutinating antibody was demonstrated 30days after sensitizing the guinea pigs with killed tubercle bacilli. The maximum titer was continued for a period of 45 days and thereafter declined gradually. 2. The swelling and redness of the region of the sensitized guinea pigs was shown to be reached to the maximum size within 24 hours after intradermal inoculation with HCSM tuberculin and gradually reduced 96 hours after inoculation. The swelling and redness could not be detected by macro-observation after 14 days.

• Korean Journal of Veterinary Research
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• v.16 no.2
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• pp.151-158
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• 1976

The tuberculin test have been widely utilized to diagnose tuberculosis of the dairy cattle. It was reported that approximately 70% of the dairy cattle with positive tuberculin reaction in Korea had been non-pathogenic lesion. So the studies on the specific method to diagnose tuberculosis of them is really need in Korea. Therefore this study investigated upon the diagnostic method for cattle tuberculosis in the aspect of cellular-immunology. The results obtained in this investigation are summarized as follows: 1. All the tuberculin tests to the swine inoculated with BCG.(B group), Mycobacterium avium (A group) and Mycobacterium smegmatis (S group), respectively, were represented high positive reaction and were no differences in the species of inoculated bacteria. 2. In the migration inhibition test using Iymphocyte in circulating blood of the swine inoculated with three species of acid-fast bacteria respectively, the test to A group was represented slight positive for migration in the presence of $15{\mu}g/ml$-PPD and the other reaction were clear and total positive for migration inhibition in the presence of $25{\mu}g/ml$-PPD or more, and the test to B group was the same results as to A group approximately. The test to S group was represented slight positive for migration inhibition in the presence of $15{\mu}g/ml$-PPD, but the results were the same in the presence of $25{\mu}g/ml$-PPD and $35{\mu}g/ml$-PPD. These results showed that there were remarkable differences between group A, B and group S in the presence of $25{\mu}g/ml$-PPD and $35{\mu}g/ml$-PPD. 3. The transformation rates of lymphocyte in PPD treated tissue culture had no significance without any relation between PPD treatment and non-treatment but A group and B group showed significance. And A group and B group showed high significance in comparison with N group and S group in the LSD examination. 4. The infection rated in lymphocyte of BCG inoculated after 3 days tissue culturing were represented those of high infection but its cellular degeneration rates almost did not change. The infection rates in bacilli in N group and S group were low but after 3 days inoculation it shewed higher cellular degeneration.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.272-275
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• 2019

The 2018 National Guideline for Tuberculosis Control, which was published by the Korea Centers for Diseases Prevention and Control (KCDC), mandates conducting an epidemiological survey among close contacts of active tuberculosis patients at public institutions such as schools. In the procedure for these surveys, the tuberculin skin test (TST) is mandated as the screening test for latent tuberculosis infection in elementary school students. However, several guidelines recommend using the interferon-gamma releasing assay (IGRA) for contacts aged over 5 years with a Bacillus Calmette-$Gu{\acute{e}}rin$ vaccination history. The main reason for this is that IGRA has a higher specificity and lower false positive rate than TST. In addition, IGRA requires only a single visit to draw blood and the results are available within 24 hours. These advantages could promote cooperation from both parents and students in conducting these surveys. Thus, these findings regarding the benefits of IGRA for surveys of close contacts at elementary schools should be incorporated into the KCDC guideline.

• Korean Journal of Veterinary Research
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• v.48 no.1
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• pp.49-52
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• 2008

The trend in the prevalence of bovine tuberculosis (BTB) in Korean dairy cattle was investigated in relation to test programs used between 1961 and 2004, during which a total of 8,961,061 dairy cows were tested and 10,248 confirmed to have BTB. The annual prevalence increased in the late 1960s, then decreased during the 1970s and 1980s, and started to increase again from the late 1990s. It seemed that the prevalence varies according to the different test program used. The prevalence of BTB was higher when the tests were performed with heat-concentrated synthetic medium (HCSM) or purified protein derivative (PPD) tuberculin alone compared to that when using combined HCSM and PPD tuberculin testing.

• Tuberculosis and Respiratory Diseases
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• v.53 no.4
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• pp.401-408
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• 2002

Background : Tuberculin skin test is a method to examine M. tuberculosis infection and has been used all over the world. But various factors make it difficult to understand testing results. In 2000, the American Thoracic Society recommended that skin test results should be decided by considering risk factors of the tested. In Korea, high tuberculosis infection rate and BCG vaccination rate make it difficult to differentiate current infection, past infection, and no infection by the skin test. This study was attempted to examine a negative predictive value of the skin test to understand how the skin test acts on deciding administration of anti-tuberculosis drug. Methods : From Mar. 1 to Jul. 31 in 2001, the test was performed for patients hospitalized in Department of Internal Medicine, Hallym University College of Medicine, Chunchon, Korea by administering Tuberculin PPD RT23 2 TU (0.1 ml)to them that has been currently used in Korea based on Mantoux method. They were decided to be infected with tuberculosis bacilli by following diagnostic standard: 1) tuberculosis bacilli was cultured in sputum by microbiological diagnostic standard or Acid-fast bacilli was proven on a microscopic examination or 2) tuberculosis bacilli was not proven in the aforesaid microbiological test by clinical diagnostic standard, while there was opinion or symptom suitable for tuberculosis by radiographic or histological standard so the doctor decided to apply the tuberculosis treatment. Results : In this study, total 210 patients except 20 patients (8.7%) among 230 hospitalized patients were evaluated. Their average age was 60±16.8 years, and male-female rate was 1.28 : 1 (male: 118, female: 92). Number of patient, who was diagnosed and decided as tuberculosis, was 53(25.2%). Pulmonary tuberculosis was found in 45 patients (84.9%); 22 patients were decided to be positive in the Acid-fast bacilli smear test by microbiological examination (culture positive: 13, culture negative: 9), and 23 patients were decided to be tuberculosis patients by clinical diagnosis standard. Tuberculosis pleuritis was found in 8 patients (15.1%); 4 patients were diagnosed and decided by histological standard, and 4 patients were decided and treated by clinical standard. In differentiating patients into 'Negative' and 'Positive' by the skin test standard of the American Thoracic Society, negative predictive value 92.3%, positive predictive value 47.3%, sensitivity and specificity were 83%, 68.8%, respectively. Conclusion : In hospitalized respiratory patients, there was high negative predictive vlaue 92.3% by tuberculin skin test, therefore skin test would be a important factor for deciding administration of anti-tuberculosis drug on negative skin test patient.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.175-180
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• 2001

Purpose : Recently in Korea since 1998, 2TU has been used instead of 5TU, which caused a confusion in interpreting tuberculin skin tests. We compared the tuberculin skin reaction to PPD(purified protein derivatives) 1TU, 2TU and 5TU. Methods : We studied tuberculin skin reaction to PPD 1TU, 2TU and 5TU on 92 infants who were vaccinated with percutaneous multiple puncture BCG vaccine(Tokyo 172 strain, Japan BCG Laboratory Co.) in neonatal period. Diameters of indurations were measured in millimeters 48~72 hours after the intradermal injection of PPD 1TU, 2TU and 5TU. Results : Among 92 infants(male : 56, female : 36), 1TU was used on 31 infants, 2TU on 31 infants and 5TU on 30 infants for tuberculin skin test. The mean diameter of induration for PPD 1TU, 2TU and 5TU were $5.7{\pm}4.2mm$, $7.1{\pm}3.7mm$, and $9.2{\pm}4.2mm$, respectively. There was no statistical difference in mean diameter of induration between 1TU and 2TU. However, when tested with 5TU, the diameter of induration was significantly larger than those of PPD 1TU and 2TU(P<0.05). Six subjects(19.4%) tested with 1TU, 9 subjects(29%) tested with 2TU and 16 subjects(53.3%) tested with 5TU had diameter of 10 mm or more. There was no statistical difference between 1TU and 2TU but for 5TU, number of subjects with diameter of 10 mm or more was significantly higher than PPD 1TU and 2TU(P<0.05). Number of subjects with induration diameter of 5 mm or more for 1TU, 2TU and 5TU was 19(61.3%), 22(71.0%) and 26(86.7%), respectively. However, there was no statistical difference. Conclusion : A new standard criteria for interpreting the tuberculin skin test with PPD 2TU should be established for clinical diagnosis of tuberculosis.

• Journal of the korean veterinary medical association
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• v.13 no.5
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• pp.311-316
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• 1977

The studies on differentiation of pathological and atypical acid fast bacteria were reported by many authers. The tuberculin skin test that is widely utilized to diagnose tuberculosis of the dairy cattle was of smaller significance for the certification o

• Korean Journal of Veterinary Service
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• v.41 no.2
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• pp.71-78
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• 2018

Bovine tuberculosis (bTB) is a wide-spread zoonotic disease in cattle, which is casued by Mycobacterium bovis that is a part of Mycobacterium tuberculosis complex (MTC). This study describes a field trial conducted in 42 herds with the history of prevalence bovine tuberculosis. Two cell-mediated immunity tests, the gamma-interferon (${\gamma}-IFN$) assay and the single intradermal tuberculin test (SIT) were applied for the diagnosis of bovine tuberculosis in 5,289 animals. The ${\gamma}-IFN$ assay presented 144 (2.7%) head of cattle with the positive result, and 112 (2.1%) head of cattle were shown to be bTB-positive by the SIT. The positive concordance was 45.5%, and the negative concordance was 98.2%. The ${\gamma}-IFN$ assay showed more positive results in younger cattle, especially between 12 and 23 months of age. It is shown that the strategic combination of both cell-mediated immunity test methods is more efficient for the detection of bTB to reduce the number of false positive individuals which are being slaughtered.

• Tuberculosis and Respiratory Diseases
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• v.78 no.2
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• pp.56-63
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• 2015

A small number of viable tuberculosis bacilli can reside in an individual with latent tuberculosis infection (LTBI) without obvious clinical symptoms or abnormal chest radiographs. Diagnosis and treatment for LTBI are important for tuberculosis (TB) control in public and private health, especially in high-risk populations. The updated 2014 Korean guidelines for TB recommend that tuberculin skin tests, interferon-gamma release assays, or a combination of the two can be used for LTBI diagnosis according to age and immune status of the host as well as TB contact history. The regimens for LTBI treatment include isoniazid, rifampicin, or isoniazid/rifampicin. However, results of drug susceptibility test from the index case must be considered in selecting the appropriate drug for recent contacts. Standardized LTBI diagnosis and treatment based on the new 2014 guidelines will contribute to the effective TB control in Korea as well as to the establishment of updated guidelines.