IDSA News - January 2009
Volume 19 Issue 1  (Plain Text Version)

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In this issue:
Top Stories
•  CDC Updates TB Diagnosis Guidelines to Include NAA Testing
•  Bills Would Extend Medicare Coverage to Home Infusion Therapy Services
•  IDSA Journal Club
Patient Care and Science
•  EIN: Conflicting Syphilis Tests Present Diagnostic Challenges
•  In the IDSA Journals
•  Updates on Salmonella, Oseltamivir Resistance
Policy and Advocacy
•  Lyme Disease Review Panel Selected
•  IDSA, HIVMA Outline Priorities for New Administration
•  VA Considers Routine HIV Testing
•  IDSA Advocacy Update: ICD-10 Codes Get Pushed Back to 2013
Your Colleagues
•  Members on the Move
•  Welcome New IDSA Members!

 

CDC Updates TB Diagnosis Guidelines to Include NAA Testing

The Centers for Disease Control and Prevention (CDC) is now recommending nucleic acid amplification (NAA) testing as part of the diagnostic criteria for tuberculosis (TB).

The Centers for Disease Control and Prevention (CDC) is now recommending nucleic acid amplification (NAA) testing as part of the diagnostic criteria for tuberculosis (TB).

NAA testing can quickly and accurately confirm samples that are positive by acid-fast bacilli (AFB) smear microscopy, particularly in settings where non-tuberculosis mycobacteria are common. It also can confirm TB infection at least a week sooner than culture.

Culture remains the gold standard, however, and is required for resistance testing.

Currently, NAA testing is not widely used in the United States, in part because clinicians have been uncertain about its value and cost-effectiveness. But CDC noted that recent studies have found that where NAA tests are used, they frequently provide the deciding factor in starting therapy. And although NAA testing is expensive, CDC said it will result in net savings because faster TB diagnosis will reduce the chances for transmission. Screening out negative cases more quickly will save the costs of isolation and contact investigations.

CDC says speeding up diagnosis of TB in patients suspected of having pneumonia will reduce the inappropriate use of empiric fluoroquinolone monotherapy, which is likely contributing to the development of fluoroquinolone-resistant TB.

The revised recommendations and testing algorithm are published in the Jan. 16 Morbidity and Mortality Weekly Report. They were developed by CDC and the Association of Public Health Laboratories.