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Free Content The complexities of Xpert® MTB/RIF interpretation

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The Xpert® MTB/RIF assay has demonstrated robust capability for diagnosing tuberculosis (TB) and rifampin (RMP) resistance. Optimal use of Xpert in diverse settings will require knowledge of challenges when interpreting the results. We present three selected cases from the United States, a low-burden TB setting, to highlight important clinical scenarios encountered with Xpert testing: rapid RMP resistance detection in a patient with pre-extensively drug-resistant TB who immigrated from the Philippines, false-positive RMP resistance detection, and Mycobacterium tuberculosis detection in a culture-negative patient. These cases demonstrate that a low pre-test probability of TB or drug-resistant TB can complicate the interpretation of the Xpert assay.
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Keywords: United States; hospital epidemiology; infection control; tuberculosis

Document Type: Research Article

Affiliations: 1: *Institute for Global Health & Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA, Right to Care, Johannesburg, South Africa 2: Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill 3: §Department of Epidemiology, University of North Carolina, Chapel Hill 4: *Institute for Global Health & Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA 5: Division of Infectious Diseases, Duke University, Durham, North Carolina, USA

Publication date: 01 March 2015

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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