To the Editor We read with interest the recent article by Chaisson and colleagues1 on the discontinuation of respiratory isolation guided by rapid molecular testing such as GeneXpert MTB/RIF (Xpert; Cepheid). The authors reported that Xpert revealed positive results in all 7 patients with culture-confirmed pulmonary tuberculosis (TB), with a wide CI of the sensitivity (100%; 95% CI, 54%-100%), and negative results in all 251 patients with suspected TB but eventually not TB. However, another study2 reported sputum specimens from about one-third of patients with paucibacillary pulmonary TB still show negative Xpert results. In addition, our previous study3 showed that Xpert assay even from bronchoalveolar lavage fluid from patients with paucibacillary pulmonary TB had a diagnostic yield of only 31%.
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Kim JY, Hong MJ, Kim S. Respiratory Isolation Based on Rapid Molecular Testing in an Intermediate Tuberculosis-Burden Country. JAMA Intern Med. 2019;179(1):124–125. doi:10.1001/jamainternmed.2018.7238
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