Use of a Single Xpert MTB/RIF Assay to Determine the Duration of Airborne Isolation in Hospitalized Patients With Suspected Pulmonary Tuberculosis

Husain Poonawala, Surbhi Leekha, Sandra Medina-Moreno, Mala Filippell, J. Kristie Johnson, Robert R. Redfield, Kapil K. Saharia
  • Infection Control and Hospital Epidemiology, March 2018, Cambridge University Press
  • DOI: 10.1017/ice.2018.25

Is a single Xpert MTB/RIF enough to rule out pulmonary TB in hospitalized patients?

What is it about?

Hospitalized patients with suspected pulmonary TB need 2-3 AFB smears to be negative before they can be taken of airborne isolation. We wanted to see if a single negative PCR test (Gene Xpert MTB/RIF) that takes 2 hours could be used to shorten the duration of airborne isolation without missing any cases.

Why is it important?

Ruling out TB in patients in a low-incidence setting in the US can be time consuming and frustrating for patients and doctors. Maintaining and operating and negative pressure rooms for airborne isolation is expensive.

Perspectives

Husain Poonawala (Author)

There were far fewer patients with TB during our study period, so we decided to look at the duration of airbrone isolation under different scenarios. We had a large number of immunosuppresed patients, which is different from most published papers in a low prevalence setting. While getting 3 AFB smears is not easy and responsible for delays, we also realised that there were delays in discontinuing airborne isolation, and that communication from the lab to providers was necessary to discontinue airborne isolation promptly.

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