The U.S. Centers for Disease Control and Prevention (CDC) recently released the 2016 Clinical Practice Guidelines for Diagnosis of Tuberculosis in Adults and Children. The guidelines—developed by CDC, American Thoracic Society (ATS), and Infectious Diseases Society of America (IDSA), and endorsed by the European Respiratory Society—update the previous tuberculosis (TB) diagnostics guidelines published by ATS/CDC/IDSA in 2000.
The newly released guidelines provide recommendations on the diagnosis of latent TB infection, pulmonary TB, and extrapulmonary TB in adults and children. The guidelines provide evidence-based recommendations that were developed with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. GRADE involves structured literature review, systematic reviews and meta-analyses of combined data, and expert discussion to assess the certainty in the evidence and determine the strength of each recommendation.
The twenty-three evidence-based recommendations include guidance for clinicians on how to employ newer tests to diagnose TB disease and latent TB infection, including interferon-gamma release assays (IGRAs) and molecular diagnostics. Although TB is less common in the United States than in other parts of the world, clinicians should consider testing patients who have a higher-risk for TB infection, including patients who were born in or who frequently travel to countries where TB disease is common; patients who live or have lived in large group settings, such as homeless shelters or prisons and jails; or those with other risk factors, as described in the guidelines.
CDC encourages local health departments to share these guidelines with their partners, especially clinicians. For more information on the diagnosis of TB and latent TB infection, please view the guidelines in Clinical Infectious Disease.