Lewinsohn David M, Leonard Michael K, LoBue Philip A, Cohn David L, Daley Charles L, Desmond Ed, Keane Joseph, Lewinsohn Deborah A, Loeffler Ann M, Mazurek Gerald H, O'Brien Richard J, Pai Madhukar, Richeldi Luca, Salfinger Max, Shinnick Thomas M, Sterling Timothy R, Warshauer David M, Woods Gail L
Oregon Health & Science University, Portland, Oregon.
Emory University School of Medicine and.
Clin Infect Dis. 2017 Jan 15;64(2):111-115. doi: 10.1093/cid/ciw778.
Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain.
A task force supported by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America searched, selected, and synthesized relevant evidence. The evidence was then used as the basis for recommendations about the diagnosis of tuberculosis disease and LTBI in adults and children. The recommendations were formulated, written, and graded using the Grading, Recommendations, Assessment, Development and Evaluation (GRADE) approach.
Twenty-three evidence-based recommendations about diagnostic testing for latent tuberculosis infection, pulmonary tuberculosis, and extrapulmonary tuberculosis are provided. Six of the recommendations are strong, whereas the remaining 17 are conditional.
These guidelines are not intended to impose a standard of care. They provide the basis for rational decisions in the diagnosis of tuberculosis in the context of the existing evidence. No guidelines can take into account all of the often compelling unique individual clinical circumstances.
感染结核分枝杆菌（Mtb）的个体可能会出现疾病症状和体征（结核病），也可能没有疾病的临床证据（潜伏性结核感染[LTBI]）。结核病是全球传染病发病和死亡的主要原因之一，但与其诊断相关的许多问题仍然存在。
由美国胸科学会、疾病控制与预防中心以及美国传染病学会支持的一个特别工作组对相关证据进行了检索、筛选和综合。然后，这些证据被用作关于成人和儿童结核病及LTBI诊断建议的基础。这些建议采用分级、推荐、评估、制定和评价（GRADE）方法进行制定、撰写和分级。
提供了23条关于潜伏性结核感染、肺结核和肺外结核诊断检测的循证建议。其中6条建议为强推荐，其余17条为有条件推荐。
这些指南并非旨在强制规定一种治疗标准。它们为在现有证据背景下进行结核病诊断的合理决策提供了基础。没有任何指南能够考虑到所有往往极具说服力的独特个体临床情况。
