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%.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
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
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: