Work flow and optional protocols for laboratories in industrialized countries

The algorithm of the mycobacteriology laboratory of the 1990s relies heavily on growth-dependent procedures that are slow and labor-intensive. The introduction of nucleic acid-based direct amplification tests portends the development of laboratories in which molecular diagnostic assays will prevail. Financial constraints mandate an interdisciplinary approach to establishing clinical pathways and rational tailoring of current protocols to curtail expensive overuse of dwindling resources.