A new clinical decision support system, "TBorNotTB," helps streamline airborne infection isolation decisions, reducing workload while maintaining TB detection accuracy. Study: TB or not TB? Development and validation of a clinical decision support system to inform airborne isolation requirements in the evaluation of suspected tuberculosis . Image Credit: SewCreamStudio/Shutterstock.
com In a recent study published in Infection Control and Hospital Epidemiology , researchers presented a clinical decision support system (CDSS) to guide the evaluation of suspected tuberculosis (TB). Background In the United States (US), TB incidence has reduced from 10.4 cases per 100,000 people in 1992 to 2.
2 cases per 100,000 in 2020, with nosocomial transmission being rare in recent years. Nevertheless, TB incidence surged to 2.9 per 100,000 people in the US in 2023.
Meanwhile, hospitals face capacity and staffing challenges, rendering decision-making for suspected TB patients more urgent. Current guidelines for suspected TB recommend testing sputum samples for mycobacterial culture and acid-fast bacilli (AFB) smear, with airborne infection isolation (AII) implemented. Nevertheless, cultures usually take ≥ two weeks, and nearly half of individuals with pulmonary TB show negative smears.
While nucleic acid amplification tests (NAATs) have greater sensitivity than AFB smears, they are significantly less sensitive than culture. As such, discontinuing NAATs and smear results would be premature a.