We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress hp
Sign In
Advertise with Us
LGC Clinical Diagnostics

Download Mobile App




Rapid Molecular Tuberculosis Testing Reduces Patient Isolation

By LabMedica International staff writers
Posted on 13 Sep 2018
Print article
Image: The GeneXpert system and MTB/RIF test cartridge for the molecular detection of Mycobacterium tuberculosis complex and rifampin resistance-associated mutations (Photo courtesy of Cepheid).
Image: The GeneXpert system and MTB/RIF test cartridge for the molecular detection of Mycobacterium tuberculosis complex and rifampin resistance-associated mutations (Photo courtesy of Cepheid).
Molecular testing appears to be associated with facilitating faster, more patient-centered care for individuals placed in respiratory isolation while undergoing evaluation for active tuberculosis (TB) in hospitals in the USA.

A major component of guidelines to prevent the spread of the disease is the isolation of suspected TB patients in negative-pressure ventilated rooms, which can last for several days because smear microscopy requires that sputum be collected from patients over the course of two or more days. Such isolation procedures are resource-intensive, not to mention difficult for the patient.

Multi-institutional scientists carried out a prospective cohort study with a pragmatic, before-and-after-implementation design of 621 consecutive patients hospitalized at Zuckerberg San Francisco General Hospital and Trauma Center (San Francisco, CA, USA) who were undergoing sputum examination for evaluation for active pulmonary TB from January 2014 to January 2016.

The team measured the proportion of patients with molecular testing ordered and completed; the accuracy of the molecular testing algorithm in reference to mycobacterial culture; the duration of each component of the testing and isolation processes; length of stay; mean days in isolation and in hospital; and mean cost. They extracted data from hospital records and compared measures before and after implementation. They implemented a sputum molecular testing algorithm using GeneXpert MTB/RIF to guide discontinuation of isolation.

The scientists reported that of the 301 pre-implementation patients who had at least one sputum microscopy test and culture ordered, 233 (77%), underwent the study's rapid TB testing evaluation process. Of the 320 patients examined after molecular testing implementation, clinicians ordered molecular testing for 234 (73%) of patients, and received results for 295 of 302 tests ordered (some patients received multiple molecular tests). The molecular testing workflow successfully diagnosed all seven patients with culture-confirmed TB and excluded the disease in 251 patients whose culture tests were negative for Mycobacterium tuberculosis. In addition, the molecular workflow detected one patient who had a negative smear test and would have otherwise gone undiagnosed.

The team noted that more importantly for the purposes of the study, when comparing the molecular with the non-molecular workflow, the median time to final rapid test result was dropped to about 24 hours from 39 hours, time to discontinuation of patient isolation was reduced to 2.5 days from 2.9 days, and time to hospital discharge fell to 4.9 days from 6.0 days. On average, this translated to an average per-patient savings of USD 13,347.

The authors concluded that a sputum molecular testing algorithm to guide discontinuation of respiratory isolation for patients undergoing evaluation for active TB was safe, feasible, widely and sustainably adopted, and provided substantial clinical and economic benefits. Molecular testing may facilitate more efficient, patient-centered evaluation for possible TB in hospitals in the USA. The study was published on August 27, 2018, in the journal JAMA Internal Medicine.

Related Links:
Zuckerberg San Francisco General Hospital and Trauma Center

Gold Member
Antipsychotic TDM Assays
Saladax Antipsychotic Assays
Verification Panels for Assay Development & QC
Seroconversion Panels
New
HIV Test
Anti-HIV (1/2) Rapid Test Kit
New
Anti-HHV-6 IgM Assay
anti-HHV-6 IgM ELISA (semiquant.)

Print article

Channels

Clinical Chemistry

view channel
Image: The tiny clay-based materials can be customized for a range of medical applications (Photo courtesy of Angira Roy and Sam O’Keefe)

‘Brilliantly Luminous’ Nanoscale Chemical Tool to Improve Disease Detection

Thousands of commercially available glowing molecules known as fluorophores are commonly used in medical imaging, disease detection, biomarker tagging, and chemical analysis. They are also integral in... Read more

Immunology

view channel
Image: The cancer stem cell test can accurately choose more effective treatments (Photo courtesy of University of Cincinnati)

Stem Cell Test Predicts Treatment Outcome for Patients with Platinum-Resistant Ovarian Cancer

Epithelial ovarian cancer frequently responds to chemotherapy initially, but eventually, the tumor develops resistance to the therapy, leading to regrowth. This resistance is partially due to the activation... Read more

Pathology

view channel
Image: The ready-to-use DUB enzyme assay kits accelerate routine DUB activity assays without compromising data quality (Photo courtesy of Adobe Stock)

Sensitive and Specific DUB Enzyme Assay Kits Require Minimal Setup Without Substrate Preparation

Ubiquitination and deubiquitination are two important physiological processes in the ubiquitin-proteasome system, responsible for protein degradation in cells. Deubiquitinating (DUB) enzymes contain around... Read more

Technology

view channel
Image: The HIV-1 self-testing chip will be capable of selectively detecting HIV in whole blood samples (Photo courtesy of Shutterstock)

Disposable Microchip Technology Could Selectively Detect HIV in Whole Blood Samples

As of the end of 2023, approximately 40 million people globally were living with HIV, and around 630,000 individuals died from AIDS-related illnesses that same year. Despite a substantial decline in deaths... Read more

Industry

view channel
Image: The collaboration aims to leverage Oxford Nanopore\'s sequencing platform and Cepheid\'s GeneXpert system to advance the field of sequencing for infectious diseases (Photo courtesy of Cepheid)

Cepheid and Oxford Nanopore Technologies Partner on Advancing Automated Sequencing-Based Solutions

Cepheid (Sunnyvale, CA, USA), a leading molecular diagnostics company, and Oxford Nanopore Technologies (Oxford, UK), the company behind a new generation of sequencing-based molecular analysis technologies,... Read more
Copyright © 2000-2025 Globetech Media. All rights reserved.