One month to one day? : can we really reduce the detection time of tubercu[l]osis that much?

Abstract

Mycobacterium tuberculosis (Mtb) remains important to clinicians and patients because it can be highly infectious and challenging to diagnose. The CDC reports that there were 10,528 cases of TB in the U.S. in 2011, and 529 deaths due to TB in 2009. The rapid diagnosis of Mtb is essential for early disease management. Equally important for clinicians is the exclusion of Mtb from the differential diagnosis. Per the University of Missouri Infection Control Manual, precautions for a patient with suspected infectious pulmonary tuberculosis include a private room with a closed door, negative air pressure, and a 'stop sign alert on the door'. This is inconvenient for patients and care providers and adds expense to the hospital stay. Patients suspected of having TB should have 3 sputum samples tested with acid fast bacilli smears and culture, and one sample should undergo nucleic acid amplification testing. Unfortunately, standard culture techniques can take a month to detect Mtb. Here we present a commercially available assay validated in our lab that reduces detection time to less than two hours.