title: What is the role for Xpert® MTB/RIF in high-resource settings? Experience from a central London hospital.
abstract: The role of Xpert(®) MTB/RIF for tuberculosis (TB) diagnosis remains to be clearly delineated in high-resource settings. At a London hospital, we evaluated a policy of selective assay use, with testing restricted to defined sub-groups of patients. Management was directly influenced in 30% of patients studied, including 'ruling-in' a TB diagnosis (leading to initiation of treatment for TB or for potential multidrug-resistant TB); negative assay results also helped support decisions for cessation of empirical anti-tuberculosis treatment or the safe initiation of other treatments such as immunosuppressant drugs. The benefits and pitfalls of this assay's use within high-resource settings are discussed.
authors.affiliation: Division of Medicine, University College London, London, UK.
authors.forename: R K
authors.initials: RK
authors.lastname: Gupta
authors.affiliation: University College Hospitals NHS Trust, London, UK.
authors.forename: S D
authors.initials: SD
authors.lastname: Lawn
authors.affiliation: University College Hospitals NHS Trust, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Booth
authors.affiliation: University College Hospitals NHS Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Morris-Jones
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D021141:Nucleic Acid Amplification Techniques; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents