High rate of Quantiferon positive and tuberculin negative tests in infants born at a large Italian University Hospital in 2011: a cautionary hypothesis

Abstract

In the summer of 2011, an outbreak of Mycobacterium tuberculosis infection was suspected, and widely publicized, to have occurred in a maternity ward of an Italian University Hospital based on a case of tuberculosis in a nurse and another case in a newborn. More than 1300 newborns in the Hospital were surveyed for the occurrence of latent TB by the use of interferon-gamma released assays, which was positive in 118 newborns, all negative at the tuberculin skin test. We present here several theoretical arguments and literature data suggesting caution in interpreting the interferon-gamma released assays positivity alone as indication of latent TB infection in newborns.

Keywords:

• Latent tuberculosis
• Interferon-gamma release assays
• Tuberculin skin test
• Newborns
• Trogocytosis
• Chimerism