{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T21:59:55Z","timestamp":1783979995015,"version":"3.55.0"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T00:00:00Z","timestamp":1522108800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec id=\"S0899823X18000259_abs1\" sec-type=\"general\"><jats:title>BACKGROUND<\/jats:title><jats:p>Hospitalized patients with suspected tuberculosis (TB) are placed in airborne isolation until 3 sputum smear samples are negative for acid-fast bacilli (AFB). The Xpert MTB\/RIF assay (\u201cXpert\u201d) nucleic acid amplification test (NAAT) to identify<jats:italic>Mycobacterium tuberculosis<\/jats:italic>DNA and resistance to rifampicin is superior to AFB sputum smear microscopy for the diagnosis of TB.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000259_abs2\" sec-type=\"general\"><jats:title>OBJECTIVE<\/jats:title><jats:p>To compare the performance of a single Xpert to AFB smear microscopy for time to airborne infection isolation (AII) discontinuation.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000259_abs3\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Consecutive patients over 17 years of age in AII for suspected pulmonary TB between October 1, 2014, and March 31, 2016, with leftover respiratory AFB samples were enrolled in this study. A single Xpert was performed on the first available sample. Demographic, clinical, and microbiological data were recorded for each patient. We compared the duration of AII using a single Xpert to AFB smear microscopy under multiple theoretical scenarios using Kaplan-Meier cumulative incidence curves and the log-rank test.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000259_abs4\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>In total, 131 samples were included in our performance analysis of the Xpert, and 114 samples were included in our AII analysis. Overall, 81 patients (65%) were immunosuppressed, of whom 46 (37%) were positive for human immunodeficiency virus (HIV). The sensitivity and specificity of Xpert for diagnosis of<jats:italic>M. tuberculosis<\/jats:italic>infection were 67% and 100%, respectively. Xpert was negative in all cases of nontuberculous mycobacteria. Use of a single Xpert reduced AII duration from a median of 67 hours per patient to 42 hours with usual reporting, to 26 hours with direct communication, and to 12 hours with immediate testing.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X18000259_abs5\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>A single negative Xpert result can reduce AII duration compared to the AFB smear microscopy technique under multiple theoretical scenarios.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic>2018;39:590\u2013595<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2018.25","type":"journal-article","created":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T09:10:36Z","timestamp":1522141836000},"page":"590-595","source":"Crossref","is-referenced-by-count":15,"title":["Use of a Single Xpert MTB\/RIF Assay to Determine the Duration of Airborne Isolation in Hospitalized Patients With Suspected Pulmonary Tuberculosis"],"prefix":"10.1017","volume":"39","author":[{"given":"Husain","family":"Poonawala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surbhi","family":"Leekha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Medina-Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mala","family":"Filippell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Kristie","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Redfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kapil K.","family":"Saharia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,3,27]]},"reference":[{"key":"S0899823X18000259_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)03406-0"},{"key":"S0899823X18000259_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu620"},{"key":"S0899823X18000259_ref13","first-page":"193","article-title":"Revised device labeling for the Cepheid Xpert MTB\/RIF assay for detecting Mycobacterium tuberculosis","volume":"64","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0899823X18000259_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ447"},{"key":"S0899823X18000259_ref5","doi-asserted-by":"publisher","DOI":"10.1086\/591974"},{"key":"S0899823X18000259_ref1","first-page":"1","article-title":"Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005","volume":"54","year":"2005","journal-title":"MMWR Recomm Rep"},{"key":"S0899823X18000259_ref20","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0095"},{"key":"S0899823X18000259_ref14","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1093\/cid\/ciw803","article-title":"Clinical impact and cost-effectiveness of Xpert MTB\/RIF testing in hospitalized patients with presumptive pulmonary tuberculosis in the United States","volume":"64","author":"Cowan","year":"2017","journal-title":"Clin Infect Dis"},{"key":"S0899823X18000259_ref10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0079669"},{"key":"S0899823X18000259_ref18","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201111-2016OC"},{"key":"S0899823X18000259_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw035"},{"key":"S0899823X18000259_ref11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0907847"},{"key":"S0899823X18000259_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu212"},{"key":"S0899823X18000259_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2011.10.005"},{"key":"S0899823X18000259_ref2","doi-asserted-by":"crossref","DOI":"10.1128\/9781555817381","volume-title":"Manual of Clinical Microbiology","author":"Jorgensen","year":"2015"},{"key":"S0899823X18000259_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2010.04.027"},{"key":"S0899823X18000259_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit336"},{"key":"S0899823X18000259_ref12","first-page":"CD009593","article-title":"Xpert(R) MTB\/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults","volume":"1","author":"Steingart","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"S0899823X18000259_ref7","doi-asserted-by":"publisher","DOI":"10.1086\/671732"},{"key":"S0899823X18000259_ref4","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2003.011759"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X18000259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:28:33Z","timestamp":1751502513000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X18000259\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,27]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["S0899823X18000259"],"URL":"https:\/\/doi.org\/10.1017\/ice.2018.25","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,27]]}}}