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. 

Together, the study developed and validated a novel CDSS to guide the diagnostic evaluation of patients with suspected TB in low-prevalence settings. Prior positive IGRA, residence in a TB-endemic country, and chest radiological findings suspicious of TB were significant predictors of TB. The final CDSS model showed modest specificity and high sensitivity in detecting TB. Overall, TBorNotTB could help reduce the risk of nosocomial transmission and save considerable IPC person-time.

Source: https://www.news-medical.net/news/20250131/TBorNotTB-A-novel-AI-driven-tool-to-streamline-tuberculosis-evaluation-in-hospitals.aspx