GeneXpert MTB/RIF

I have worked really hard to kind of tailor my career to be still heavily involved in the infection prevention world, but a micro lab director at the same time.

So some primary things that I think about that we instituted at our hospital recently are MTB RIF PCR testing, we did that a few years ago.

But because of the infection prevention practices around positive TB testing, we really had to work with infection prevention with when can this test be ordered? You know, once again, those behind the scenes tests, type of questions and policies and practices that we implement around these tests but who actually can get tested for this what type of specimens should we be testing for this because you know if it's something that's completely contained if it's you know, not something where we would typically be putting the patient in traditional TB isolation for, then maybe they don't need this rapid diagnostic after all.

And then how many samples are appropriate for testing? And do we retest? If a patient's positive or had a previous positive, what kind of is that timeline for retesting? Because one of the big things that you want to prevent You want to give clinicians information they need to treat, but you also want to stop this, oh, this patient goes on isolation.

There were some questions about mold and tubing for a while, and a couple of patients on that unit all had mold infections.

And so looking at little things like that is helpful, but that's more esoteric and not something that you're doing day in and day out on the bench regularly.

As a tech, I would say, you know, that MTB RIF testing is huge because it's expensive on the lab side.

You don't want to be over utilizing it, but you also really want to make sure that the patients that need to be isolated quickly are getting isolated quickly.

Completely agree.

Well, I guess maybe, maybe turning, um, to an example where it did work rather well, which is the really humongous explosion of GeneXpert systems for MTB RIF.

Um, I can remember, you know, starting out my job at UCLA and having our ID doctors complain because they could get the PCR when they were doing their tours in Africa, but they couldn't get it in our lab [laughs].

[laughs]

Yeah.

And then for the lab, there's a GeneXpert.

Mm-hmm.

And then for the imaging, there's a chest X-ray.

Yes.

You know? Yeah.

To also just maybe have a, I don't know, the GeneXpert as routine, and maybe be m- or maybe be more keen on- Yeah ...

the chest X-ray because you...