{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T13:12:20Z","timestamp":1788873140681,"version":"build-2803163510"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26104863_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The GeneXpert\u00ae MTB\/RIF nucleic acid amplification test has been proposed as an alternative method to smear microscopy in guiding de-isolation for patients with suspected pulmonary tuberculosis, given its convenience and higher diagnostic accuracy. Currently, there is no comprehensive review summarizing the evidence on the isolation duration using GeneXpert. This systematic review and meta-analysis addressed the length of airborne infection isolation in hospitalized patients initially suspected of having pulmonary tuberculosis where de-isolation decisions were guided by GeneXpert nucleic acid amplification test compared to traditional smear microscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104863_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a comprehensive search in databases (Medline, Embase, and Scopus) from January 1, 2001, to April 1, 2026, and applied median-based quantile estimation methods to determine the pooled difference in median times of isolation. We also assessed diagnostic accuracy as well as hospital length of stay as secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104863_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We screened 746 titles and abstracts, of which 7 were eligible for inclusion. Five studies included in the meta-analysis involved 1,409 patients, all within low-incidence tuberculosis settings. The meta-analysis demonstrated that use of a single unconcentrated GeneXpert versus serial acid-fast bacilli smear microscopy resulted in a pooled reduction in median isolation duration by 38.8 hours (95% confidence interval 20.2\u201357.3 hours).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26104863_as4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Compared to serial microscopy, GeneXpert done on a single unconcentrated respiratory specimen reduces airborne infection isolation duration by over 1.5 days, on average, making it an attractive strategy for optimizing healthcare facility resources while evaluating persons for pulmonary tuberculosis.<\/jats:p>\n                    <jats:p>Protocol Registration (PROSPERO, CRD42024538644)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10486","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T09:58:21Z","timestamp":1783936701000},"page":"885-893","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["The impact on airborne isolation duration utilizing GeneXpert versus acid-fast bacilli smears to guide discontinuation among individuals with suspected pulmonary tuberculosis: a systematic review and meta-analysis"],"prefix":"10.1017","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7280-6941","authenticated-orcid":false,"given":"David","family":"Campbell","sequence":"first","affiliation":[{"name":"Cumming School of Medicine, University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5927-5197","authenticated-orcid":false,"given":"Chanhee","family":"Seo","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-8497","authenticated-orcid":false,"given":"Alexander A.","family":"Leung","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary"},{"name":"Cumming School of Medicine, University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3958-7561","authenticated-orcid":false,"given":"Paul E.","family":"Ronksley","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4449-4447","authenticated-orcid":false,"given":"Rachel K.","family":"Lim","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary"},{"id":[{"id":"https:\/\/ror.org\/03yjb2x39","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"S0899823X26104863_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.chemosphere.2022.134805"},{"key":"S0899823X26104863_ref32","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.21.0130"},{"key":"S0899823X26104863_ref26","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.3638"},{"key":"S0899823X26104863_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.14.1899"},{"key":"S0899823X26104863_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa439.862"},{"key":"S0899823X26104863_ref20","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu620"},{"key":"S0899823X26104863_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2024.214"},{"key":"S0899823X26104863_ref14","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.11.84"},{"key":"S0899823X26104863_ref4","first-page":"1","article-title":"Controlling tuberculosis in the United States. Recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America","volume":"54","author":"Taylor","year":"2005","journal-title":"MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep"},{"key":"S0899823X26104863_ref11","first-page":"CD009593","article-title":"Xpert Ultra versus Xpert MTB\/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis. Cochrane Infectious Diseases Group, ed","volume":"2","author":"Zifodya","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"S0899823X26104863_ref10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0079669"},{"key":"S0899823X26104863_ref29","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.37"},{"key":"S0899823X26104863_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.201900036"},{"key":"S0899823X26104863_ref33","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.24260"},{"key":"S0899823X26104863_ref18","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"S0899823X26104863_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa189"},{"key":"S0899823X26104863_ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"S0899823X26104863_ref25","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw803"},{"key":"S0899823X26104863_ref2","first-page":"1","article-title":"Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005","volume":"54","author":"Jensen","year":"2005","journal-title":"MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep"},{"key":"S0899823X26104863_ref31","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae253"},{"key":"S0899823X26104863_ref24","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.96"},{"key":"S0899823X26104863_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw778"},{"key":"S0899823X26104863_ref19","volume-title":"Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Version 2.0 (updated July 2023)","author":"Takwoingi","year":"2023"},{"key":"S0899823X26104863_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.1686"},{"key":"S0899823X26104863_ref15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"S0899823X26104863_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.01.022"},{"key":"S0899823X26104863_ref5","first-page":"1","article-title":"Patient isolation precautions: are they worth it?","volume":"2016","author":"Sprague","year":"2016","journal-title":"Can Respir J"},{"key":"S0899823X26104863_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2013.10.014"},{"key":"S0899823X26104863_ref12","unstructured":"12. Bernardo, J , Warshauer, D , Anderson, E , et\u00a0al. Consensus statement on the use of Cepheid Xpert MTB\/RIF assay in making decisions to discontinue airborne infection isolation in healthcare settings. https:\/\/tbcontrollers.org\/docs\/resources\/NTCA_APHL_GeneXpert_Consensus_Statement_Final.pdf. Published online April 2016. Accessed July 7, 2025."},{"key":"S0899823X26104863_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2023.07.010"},{"key":"S0899823X26104863_ref27","unstructured":"27. Xpert MTB\/RIF Package Insert. https:\/\/web-support.cepheid.com\/Package%20Insert%20Files\/Xpert-MTB-RIF-ENGLISH-Package-Insert-301-1404-Rev-G.pdf. Published online July 2020. Accessed July 7, 2025."},{"key":"S0899823X26104863_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu212"},{"key":"S0899823X26104863_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2018.25"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26104863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:59:31Z","timestamp":1788872371000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26104863\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":33,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S0899823X26104863"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10486","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}