Serhat SİREKBASAN, Harika Öykü DİNÇ, Doğukan ÖZBEY, Bekir Sami KOCAZEYBEK, Seher AKKUŞ, Suat SARIBAŞ

Cerrahpaşa Tıp Fakültesi Kliniklerinden İstemi Yapılan QuantiFERON-TB Gold Test Sayıları ve Sonuçları ile Paralel Olarak Klinik Kullanımdaki Yeri: 2 Yıllık Retrospektif Değerlendirme

Amaç: Bu retrospektif çalışma Cerrahpaşa Tıp Fakültesi’nin farklı kliniklerinden spesifik amaçlara dönük istemi yapılan QuantiFERON-TB Gold (QFT)testinin kullanım sıklığının ve sonuçlarının belirlenmesi ile bu testin kliniğin amaçlarına dönük uygunluğunun olup olmamasının değerlendirilmesiamacıyla yapılmıştır.Gereç ve Yöntem: Ocak 2018-Aralık 2019 tarihleri arasında çeşitli kliniklerden gönderilen ve laboratuvarda tam kan örneğinden ticari kitinöngörüleri doğrultusunda in vitro çalışması yapılan QFT testinin istem yapan kliniklere göre sayısı ve sonuçları retrospektif olarak belirlenmiş vedeğerlendirmeye alınmıştır.Bulgular: Çeşitli kliniklerden gönderilen 1.207 hastaya ait tam kan örneklerinin 151’inde (%12,5) pozitiflik saptanmıştır. Test isteminin en sık 297(%24,6) olgu ile nöroloji kliniğinden yapıldığı, bunu sırasıyla 235 (%19,5) ve 142 (%11,8) olgu ile romatoloji ve enfeksiyon hastalıkları kliniklerinintakip ettiği tespit edilmiştir. Test istemi yapan birimler arasında en sık pozitif saptama oranının göz hastalıkları kliniğinden olduğu belirlenmiştir.Sonuç: Testin istem sıklığının özellikle göğüs hastalıkları ve enfeksiyon hastalıkları kliniklerinde fazla olması beklenirken onların yerine nöroloji veromatoloji kliniklerinde daha fazla olması, buna karşın yüksek pozitifliğin göz hastalıkları kliniğinde görülmesi dikkat çekicidir. QFT testinin kliniklerdüzeyinde test istem sayısına ve buna bağlı pozitiflik sonuç ilişkisine bakıldığında amaca dönük istem sayısı ile alınan pozitiflik sonucu arasında biruyumsuzluk olduğu belirlenmiştir. Hem ticari kitin maliyeti hem de alınan pozitiflik sonuçlarının klinisyenlere yol göstericiliği hususundaki etkinlikgöz önüne alındığında kliniklere göre test isteminin ulusal algoritmalar düzeyinde tekrar gözden geçirilmesinin yararlı olacağı kanaatindeyiz.

The Frequency and Results of QuantiFERON-TB Gold Test in Parallel with the Place of the Clinical Usage in the Cerrahpaşa Medical Faculty Clinics: A 2-year Retrospective Evaluation

Objectives: We aimed to evaluate the relevancy of QuantiFERON-TB Gold (QFT) test which was required for the specific aims from the various clinics of Cerrahpaşa Medical Faculty by determining the using frequency and results of the QFT test in this retrospective study. Materials and Methods: The in vitro studies of QFT test were performed from the whole blood samples according to the manufacturer’s recommendations between January 2018 and December 2019. The numbers and results of QFT test were retrospectively determined according to the required clinics and were taken into consideration. Results: The test positivity was detected in 151 (12.5%) from the whole blood samples of 1,207 patients from various clinics. It was determined that the test request was made most frequently from the neurology clinic with 297 (24.6%) cases, followed by the rheumatology and infectious diseases clinics with 235 (19.5%) and 142 (11.8%), respectively. It was also determined that the most common positivity detection rate among the clinics requesting the test was from the ophthalmology clinic. Conclusion: It is noteworthy that the frequency of the test request was expected to be higher in the chest diseases and infectious diseases clinics, but unexpectantly, test request frequency was rather higher in the neurology and rheumatology clinics, whereas the high positivity in the test request was observed in the ophthalmology clinic. When the QFT test was examined on the number of test requests in the clinics and the relation between positive results, it was determined that there was a discrepancy between the number of purposeful requests and the positive result obtained. Considering the effectiveness of both the cost of the commercial kit and the positive results obtained in guiding clinicians, we believe that it would be beneficial to review the test requests at the national algorithms level by clinics.

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