Samples from patients with suspected TB were assayed for TB and drug resistance with several different techniques. An automated molecular test showed a sensitivity of 98% in smear-positive, culture-positive samples and a sensitivity of 72–90% in smear-negative, culture-positive samples, and it identified rifampin resistance >97% of the time. Only a small fraction of the estimated 500,000 patients who have multidrug-resistant tuberculosis and 1.37 million patients who have coinfection with tuberculosis and the human immunodeficiency virus (HIV) worldwide each year have access to sufficiently sensitive case detection or drug-susceptibility testing. 1 Diagnostic delay, aggravated by the disproportionate frequency of smear-negative disease in HIV-associated tuberculosis, is common. 2 – 5 The failure to quickly recognize and treat affected patients leads to increased mortality, secondary resistance (including extensively drug-resistant tuberculosis), and ongoing transmission. 6 , 7 The complexity of mycobacterial culture and current nucleic acid–amplification technologies for the detection of tuberculosis and multidrug-resistant tuberculosis 8 and the . . .