Two techniques of measurement of the delayed hypersensitivity skin test response for the assessment of bacterial host resistance

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Abstract
We evaluated 2 methods for measuring the delayed hypersensitivity skin test response and related the data to clinical outcome in 586 subjects. Individual intradermal injections of 5 recall antigens and a saline control (Candida, mumps, PPD, trichophytin, and Varidase®) were used in one arm. A specially designed device that applied, simultaneously, 7 antigens and a glycerin control (tetanus, diphtheria, strep antigen, old TB,Candida, Trichophytin, andProteus mirabilis) was used at a separate site. Mean diameters of induration were recorded at 24 and 48 hours. Sepsis was defined as a bacteremia or an abscess identified at surgery or autopsy. Regression analysis of the sums of the mean diameters of induration of the first skin test response obtained by each of the 2 methods showed a positive correlation between the individual antigen technique and the multitest technique (n=1508, X=0.29Y+1.6, r2= 0.633,ppp*ln(DTH score) r2= −0.89,p*ln(DTH score) r2= −0.79,p<0.001. Patient acceptance of both tests was equal. Both techniques of assessing the DTH response demonstrated a close association with bacterial sepsis, and are useful tools for assessing host resistance in surgical patients.