Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Pyrosequencing for the Clinical Management of TB

Clin Infect Dis; ePub 2018 Nov 1; Lowenthal, et al

When pyrosequencing (PSQ) was used, patients with multidrug resistant tuberculosis (MDR-TB) initiated effective treatment 5 weeks earlier compared to those without PSQ. Researchers evaluated the impact of the PSQ assay on the clinical management of TB in California. They analyzed TB surveillance and laboratory data for specimens submitted from August 1, 2012 to December 31, 2016 to determine time to effective treatment initiation. Among the findings:

  • Of 1,957 specimens tested with PSQ, 52% were sediments and 46% were culture isolates, submitted 8 and 35 days (median) after collection, respectively.
  • Among 36 patients with MDR-TB who had a sediment specimen submitted for PSQ, median time from specimen collection to MDR-TB treatment initiation was 12 days vs 51 days when PSQ was not used.
  • Of 303 TB patients with a completed survey, 126 (42%) clinicians reported PSQ as a reason for treatment change.


Lowenthal P, Lin SG, Desmond E, Shah N, Flood J, Barry PM. Evaluation of the impact of a sequencing assay for detection of drug resistance on the clinical management of tuberculosis. [Published online ahead of print November 1, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy937.

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