Clinical mycobacteriology. 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 future laboratories where molecular diagnostic assays will prevail. Financial constraints mandate an interdisciplinary approach to establish clinical pathways and rational tailoring of current protocols to curtail expensive overuse of dwindling resources.