{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T12:56:23Z","timestamp":1780318583430,"version":"3.54.1"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017610","name":"Shenzhen Science and Technology Innovation Program","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017610","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The recombinant mycobacterium tuberculosis fusion protein ESAT6-CFP10 skin test (ECST) is a novel test for tuberculosis (TB) infection; however, its accuracy in active tuberculosis (ATB) remains uncertain. This study aimed to evaluate the accuracy of ECST in the differential diagnosis of ATB for an early real-world assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective cohort study recruited patients suspected of ATB in Shanghai Public Health Clinical Center from January 2021 to November 2021. The diagnostic accuracy of the ECST was evaluated under the gold standard and composite clinical reference standard (CCRS) separately. The sensitivity, specificity, and corresponding confidence interval of ECST results were calculated, and subgroup analyses were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Diagnostic accuracy was analyzed using data from 357 patients. Based on the gold standard, the sensitivity and specificity of the ECST for patients were 72.69% (95%CI 66.8%-78.5%) and 46.15% (95%CI 37.5%-54.8%), respectively. Based on the CCRS, the sensitivity and specificity of the ECST for patients were 71.52% (95%CI 66.4%-76.6%) and 65.45% (95%CI 52.5%-78.4%), respectively. The consistency between the ECST and the interferon-\u03b3 release (IGRA) test is moderate (Kappa = 0.47).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ECST is a suboptimum tool for the differential diagnosis of active tuberculosis. Its performance is similar to IGRA, an adjunctive diagnostic test for diagnosing active tuberculosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:uri>http:\/\/www.chictr.org.cn<\/jats:uri>, identifier ChiCTR2000036369.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2023.1162177","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T06:33:10Z","timestamp":1682490790000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Utility of recombinant fusion protein ESAT6-CFP10 skin test for differential diagnosis of active tuberculosis: A prospective study"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuan","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoyu","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuhui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuihua","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"B1","volume-title":"Global tuberculosis report 2022","year":"2022"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1099\/00221287-144-11-3195","article-title":"A mycobacterium tuberculosis operon encoding ESAT-6 and a novel low-molecular-mass culture filtrate protein (CFP-10)","volume":"144","author":"Berthet","year":"1998","journal-title":"Microbiol (Reading Engl)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1128\/CDLI.7.2.155-160.2000","article-title":"Diagnosis of tuberculosis based on the two specific antigens ESAT-6 and CFP10","volume":"7","author":"van Pinxteren","year":"2000","journal-title":"Clin Diagn Lab Immunol"},{"key":"B4","volume-title":"WS 288-2017 tuberculosis diagnosis","year":"2017"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.medmal.2012.08.003","article-title":"Performance of QuantiFERON for the diagnosis TB[J]","volume":"42","author":"Meyssonnier","year":"2012","journal-title":"Med Mal Infect"},{"key":"B6","first-page":"P2787","article-title":"Experience of using diaskintest in adult patients with tuberculosis and non-tuberculosis respiratory diseases in a regional TB hospital","volume":"42","author":"Pankratova","year":"2013","journal-title":"Eur Respir 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One"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab472","article-title":"Sensitivity, specificity and safety of a novel skin test (ESAT6-CFP10) for tuberculosis infection in China: randomized, blinded, self-controlled, parallel-group phase 2b trials","volume":"74","author":"Xu","year":"2022","journal-title":"Clin Infect Dis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1186\/s12879-020-05413-9","article-title":"Induration or erythema diameter not less than 5 mm as results of recombinant fusion protein ESAT6-CFP10 skin test for detecting m tuberculosis infection","volume":"20","author":"Zhang","year":"2020","journal-title":"BMC Infect Dis"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1162177\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T06:33:14Z","timestamp":1682490794000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.1162177\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,25]]},"references-count":11,"alternative-id":["10.3389\/fimmu.2023.1162177"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2023.1162177","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,25]]},"article-number":"1162177"}}