title: Impact of the Xpert(®) MTB/RIF molecular test on the late diagnosis of pulmonary tuberculosis.
abstract: We analysed the impact of the Xpert(®) MTB/RIF molecular test on health-care diagnostic delay among tuberculosis patients. Diagnostic delay was 17.2 days (standard deviation 23.2, median 10 days). Of 128 patients recruited into the study, 60 (47%) were smear-negative; of these, 40 (67%) were Xpert-positive and were started on treatment without culture. The sensitivity of smear microscopy was 53% compared with 82% for Xpert. In smear-negative patients, delay in Xpert-positive and -negative patients was respectively 15.5 ± 13.2 and 25.5 ± 12.5 days (P = 0.002). We conclude that Xpert results were significantly associated with shorter health-care diagnostic delay, particularly in smear-negative patients.
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: H L Buchelli
authors.initials: HL
authors.lastname: Ramirez
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: M M
authors.initials: MM
authors.lastname: García-Clemente
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Alvarez-Álvarez
authors.affiliation: Servicio de Microbiología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: J J
authors.initials: JJ
authors.lastname: Palacio-Gutierrez
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Pando-Sandoval
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Gagatek
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Arias-Guillén
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: C A
authors.initials: CA
authors.lastname: Quezada-Loaiza
authors.affiliation: Área de Gestión Clínica del Pulmón, Unidad de Neumología, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Casan-Clará
mesh_terms: D000293:Adolescent; D000328:Adult; D001431:Bacteriological Techniques; D004269:DNA, Bacterial / Q000235:genetics* / Q000302:isolation & purification; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial