When to Perform a Yearly TB Skin Test

In August of 2021, the Indiana Department of Health provided updated guidance on the Tuberculosis assessment and testing requirements of residents of long term care facilities. During the Probari clinical review process, our team often finds evidence of continued application of outdated TB testing guidance, specifically continued practice of administering an annual Mantoux/Tuberculin Skin Test (TST) for standard screening.

Per the 2021 updated guidance provided by our State Department of Health, repeat testing after negative TB testing on admission is not required; unless one of the following conditions are met:

1. An exposure to an infectious case of TB.

2. As a diagnostic aid when a resident is suspected of having TB disease.

3. When the long-term care facility has evidence of ongoing TB transmission within the facility.

4. Prior to a resident’s initiating treatment with tumor necrosis factor-alpha (TNF-α) antagonists or other biologics that cause immunosuppression. In such cases, additional testing with multiple test platforms may be needed to help exclude latent TB infection.