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(Chest. 1994;106:1463-1465.)
© 1994 American College of Chest Physicians

Influence of Needle Gauge in Mantoux Skin Testing

Patricia M. Flynn M.D.1; Jerry L. Shenep M.D.1; Lian Mao M.S.2; Rosemary Crawford R.N.2; Bonnie F. Williams R.N.2; and Bobby G. Williams B.S.2

1 From the Department of Pediatrics, University of Tennessee, Memphis, Tenn.
2 From the Departments of Infectious Diseases and Biostatistics, St. Jude Children's Research Hospital, Memphis, Tenn.

Study objective: To determine the influence of needle gauge in Mantoux skin testing for tuberculosis.

Design: Randomized selection of either a 27- or 30-gauge needle for Mantoux skin test placement; observer-blinded.

Setting: Annual hospital employee screening.

Participants: Six hundred twenty-five employees working in clinical and laboratory research environments.

Results: Blinded observers found that the use of 27-gauge needles caused increased bleeding and bruising compared with 30-gauge needles (ple0.007 for each). However, the 27-gauge needle produced larger blebs and less leakage of tuberculin solution (ple0.0003).

Conclusion: Smaller gauge needles could potentially cause false-negative screening results because of decreased antigen delivery. Use of needle gauges smaller than 27 gauge should be avoided until their reliability is validated.

Key Words: employee health • Mantoux test • PPD • purified protein derivative • tuberculosis

Submitted on December 28, 1993
Accepted on March 29, 1994






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Copyright © 1994 by the American College of Chest Physicians.