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Molecular tests are increasingly used for rapid diagnosis of tuberculosis (TB). In 2015, the FDA approved revised labeling of the Xpert MTB/Rif assay to allow one or two negative sputum specimen results to be used instead of acid-fast bacilli (AFB) smear results to aid in the decision to discontinue airborne isolation. Guidelines based on this assay were published in 2016 (NEJM JW Infect Dis Aug 2016 and consensus statement). Little has been published about implementation of such a strategy. Now, investigators report the impact of using molecular testing as part of a TB isolation algorithm.
During the 1-year preimplementation phase, the decision to discontinue TB precautions relied on conventional sputum AFB smears. During the 1-year postimp…