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Related Experiment Videos

Nosocomial tuberculosis

A Catanzaro

    The American Review of Respiratory Disease
    |May 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Hospital staff can contract tuberculosis (TB) from patients, even those who are smear-negative. Procedures like bronchoscopy pose a significant TB transmission risk, highlighting the need for enhanced airborne infection control measures.

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    Area of Science:

    • Infectious Diseases
    • Occupational Health
    • Respiratory Medicine

    Background:

    • Hospital employees face occupational risks of tuberculosis (TB) infection from patients.
    • While smear-positive cases are typical sources, smear-negative patients also present a risk.
    • A respiratory intensive care unit (RICU) setting involves aerosol-generating procedures that can increase transmission risk.

    Purpose of the Study:

    • To assess the risk of TB transmission from a smear-negative, culture-positive patient to hospital staff.
    • To evaluate the impact of aerosol-generating procedures on TB transmission within a healthcare setting.
    • To determine the effectiveness of airborne infection control measures in preventing TB spread.

    Main Methods:

    • A retrospective cohort study design was used to track skin test conversions in hospital staff.

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  • Purified protein derivative (PPD) skin testing was administered to assess TB exposure.
  • Statistical analysis, including Fischer's exact test, was employed to compare conversion rates between exposed and unexposed groups.

    • Main Results:

    • 31% (14 of 45) of susceptible hospital staff exposed to the index case showed PPD skin test conversion.
    • Staff present during bronchoscopy had a significantly higher conversion rate (77%) compared to those not present (12.5%).
    • Calculations indicated substantial infectious aerosol generation during bronchoscopy and intubation.

    Conclusions:

    • Smear-negative, culture-positive TB patients can transmit infection, particularly during aerosol-generating procedures.
    • Bronchoscopy and intubation significantly increase the risk of TB transmission to healthcare workers.
    • Enhanced ventilation, high-efficiency particulate air (HEPA) filtration, and ultraviolet (UV) irradiation are crucial for controlling airborne TB transmission.