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Free Content Skin test reactivity to mycobacterial antigens parallels the phylogenetic structure of their genus

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SETTING: City of Manaus, Amazonas, Brazil.

OBJECTIVE: To explore the relationship between positivity to tuberculin and other environmental mycobacteria sensitins, according to a range of criteria and presence of BCG scar.

DESIGN: Dual skin testing with tuberculin and four mycobacterial sensitins, and BCG scar recording of 1070 schoolchildren aged 7–14. Four criteria for positivity were used: simple and dominant, with 5 and 10 mm cut-off points.

RESULTS: The standardised prevalence of reactions 5 mm for BCG scar negative children was 58.3% for Mycobacterium avium, 54.2% for M. scrofulaceum, 26.8% for M. fortuitum, 17.9% for M. tuberculosis and 7.6% for M. kansasii. Correlations between tuberculin and each sensitin, for BCG scar negative children, were 0.47 for M. avium, 0.53 for M. scrofulaceum, 0.60 for M. kansasii and 0.22 for M. fortuitum (all with P < 0.01). BCG effect was particularly significant for tuberculin (odds ratio 5 = 3.44 for reactions 5 mm, P < 0.001) and influenced the balance between dominant/non-dominant re-actions for all sensitins.

CONCLUSION: The correlation between tuberculin and each sensitin confirmed the separation of the rapidly (M. fortuitum) and slowly growing mycobacteria (M. tuberculosis, M. avium, M. scrofulaceum and M. kansasii). The influence of BCG on tuberculin reactions was more marked than on other mycobacterial sensitins.
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Keywords: BCG; Brazil; PPD; dual skin test; sensitin; tuberculin

Document Type: Regular Paper

Affiliations: 1: London School of Hygiene and Tropical Medicine, London University, London, UK 2: Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Bahia, Brazil

Publication date: July 1, 2001

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on lung health world-wide.

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