{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T01:02:56Z","timestamp":1780362176194,"version":"3.54.1"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:p><jats:bold>SETTING:<\/jats:bold> Due to purified protein derivative (PPD) RT23 stock-outs in 2014, PPD-Tubersol and PPD-Bulbio have been used for latent tuberculosis infection (LTBI) testing in the Netherlands.<jats:bold>OBJECTIVE:<\/jats:bold> To determine whether PPD-RT23, PPD-Tubersol and PPD-Bulbio were associated\n with differential indurations and confirmation using interferon-gamma release assays (IGRAs).<jats:bold>DESIGN:<\/jats:bold> LTBI surveillance data from 2013 to 2016 were extracted. Regression analyses were used to determine whether IGRA confirmation of TST-positive indurations depended on PPD, controlling\n for sex, age, incidence in country of origin, and bacille Calmette-Gu\u00e9rin (BCG) status.<jats:bold>RESULTS:<\/jats:bold> A total of 20\u2009956 individuals were tested with PPD-RT23: 10\u2009382 with PPD-Tubersol and 18\u2009562 with PPD-Bulbio. Overall, 21% with PPD-Bulbio had an induration\n of \u22655 mm compared to 12% of those tested with PPD-RT23 and PPD-Tubersol. Compared to PPD-RT23, PPD-Bulbio indurations \u22655 mm were significantly less often IGRA-confirmed among contacts (aOR 1.3, 95% CI 1.1\u20131.6) and BCG-vaccinated immigrants (PPD-RT23, aOR 2.4, 95% CI 1.4\u20134.1).\n Increasing the PPD-Bulbio cut-off from \u22655 to \u226510 mm would save respectively 26%, 42%, and 35% of IGRAs among contacts, health care workers (HCWs) and BCG-vaccinated immigrants, with small absolute numbers of positive IGRAs missed (range 0\u201355 annually).<jats:bold>CONCLUSION:<\/jats:bold> PPD-Bulbio\n shows larger TST indurations than other PPDs, but is less often IGRA-confirmed. Increasing the TST cut-off from 5 to 10 mm prior to testing with an IGRA in HCWs and immigrants is recommended.<\/jats:p>","DOI":"10.5588\/ijtld.18.0838","type":"journal-article","created":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T10:28:49Z","timestamp":1578911329000},"page":"1327-1334","source":"Crossref","is-referenced-by-count":6,"title":["Tuberculin skin test reaction depends on type of purified protein derivative: implications for cut-off values"],"prefix":"10.5588","volume":"23","author":[{"given":"C.","family":"Mulder","sequence":"first","affiliation":[{"name":"KNCV Tuberculosis Foundation, The Hague, Amsterdam Institute for Global Health and Development, Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Erkens","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, The Hague"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kouw","sequence":"additional","affiliation":[{"name":"Public Health Service Amsterdam, Amsterdam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Huisman","sequence":"additional","affiliation":[{"name":"Public Health Service The Hague, The Hague"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Toumanian","sequence":"additional","affiliation":[{"name":"Public Health Service Twente Region, Enschede"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"van den Hof","sequence":"additional","affiliation":[{"name":"KNCV Tuberculosis Foundation, The Hague, The Netherlands National Institute for Public Health and the Environment, Bilthoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2019\/00000023\/00000012\/art00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T04:33:27Z","timestamp":1615437207000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.18.0838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,1]]},"references-count":0,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12,1]]}},"alternative-id":["1027-3719(20191201)23:12L.1327;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.18.0838","relation":{},"ISSN":["1027-3719"],"issn-type":[{"value":"1027-3719","type":"print"}],"subject":[],"published":{"date-parts":[[2019,12,1]]}}}