Blog | Wednesday, April 24, 2013

Good riddance to TB testing

We suspended our tuberculin skin test program for health care workers due to the nationwide shortage of tuberculin. I say, Glory Hallelujah! I can't think of a more poorly performing test. Really, it's junk. And we've reached a point at our hospital that no health care worker will take isoniazid after a positive skin test until an interferon-gamma release assay has been done and is positive. However, there doesn't appear to be a good correlation between the skin test and the IGRA, so when the two tests are discordant, it's a coin toss as to which is the true result. To complicate matters even more, there's also a nationwide shortage of isoniazid. And don't even get me started on the use of isoniazid to treat latent TB (see here).

Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Richmond, Va., with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. This post originally appeared at the blog Controversies in Hospital Infection Prevention.