Xpert速 MTB/RIF Shortens Airborne Isolation for Hospitalized Patients with Presumptive Tuberculosis in the United States
Xpert速 MTB/RIF Shortens Airborne Isolation for Hospitalized Patients with Presumptive Tuberculosis in the United States
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DOI：
10.1093/cid/ciu212
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发表时间：
2014-07-15
影响因子：
11.8
通讯作者：
Van Rie, Annelies
中科院分区：
文献类型：
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作者：
Lippincott, Christopher K.;Miller, Melissa B.;Van Rie, Annelies
背景。在美国，疑似肺结核患者被置于空气传播感染隔离 (AII) 中，并通过涂片显微镜对间隔 8-24 小时收集的三份呼吸道标本进行评估。 Xpert (R) MTB/RIF (Xpert) 对一个、两个或三个样本可能更有效地确定 AII 停药。方法。这项针对疑似肺结核住院患者的单中心观察性队列研究纳入了成年人，并提交了一份或多份痰标本进行涂片显微镜检查。对每个痰标本进行涂片显微镜检查和Xpert检查。临床医生对 Xpert 结果视而不见。主要终点是 AII 持续时间。次要终点是实验室处理时间、基于策略的结核病检测以及敏感性和特异性。结果。在 207 名受试者中，涂片显微镜检查的中位 AII 持续时间为 68.0 小时（四分位距 (IQR)：47.1、97.5），而单样本 Xpert 的中位 AII 持续时间为 20.8 小时（IQR：16.8、32.0），两样本 Xpert 的中位 AII 持续时间为 41.2 小时（IQR：26.6、54.8），三样本 Xpert 策略为 54.0 小时（IQR：43.3、80.0）（p
Background. In the United States, individuals with presumptive pulmonary tuberculosis are placed in airborne infection isolation (AII) and assessed by smear microscopy on three respiratory specimens collected 8-24 hours apart. Xpert (R) MTB/RIF (Xpert) on one, two, or three specimens may be more efficient for determining AII discontinuation.Methods. This single-center, observational cohort study of inpatients with presumptive pulmonary tuberculosis enrolled adults with one or more sputum specimens submitted for smear microscopy. Smear microscopy and Xpert were performed on each sputum specimen. Clinicians were blinded to Xpert results. Primary end point was AII duration. Secondary end points were laboratory processing time, strategy-based tuberculosis detection, and sensitivity and specificity.Results. Among 207 subjects, the median AII duration was 68.0 hours (interquartile range (IQR): 47.1, 97.5) for smear microscopy compared to 20.8 hours (IQR: 16.8, 32.0) for the one-specimen Xpert, 41.2 hours (IQR: 26.6, 54.8) for the two-specimen Xpert, and 54.0 hours (IQR: 43.3, 80.0) for the three-specimen Xpert strategies (p