GuidelinesforPreventingtheTransmissionofM.tuberculosis

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1、GuidelinesforPreventingtheTransmissionofM.tuberculosisinHealth-CareSettings,2005DivisionofTuberculosisEliminationDecember2006note:Slide#123hasbeenedited.Purposeof2005GuidelinesUpdateandreplace1994Mycobacteriumtuberculosisinfectioncontrol(IC)guidelinesFurt

2、herreducethreattohealth-careworkers(HCWs)ExpandguidelinestonontraditionalsettingsSimplifyproceduresforassessingriskPromotevigilanceandexpertiseneededtoavertanotherTBresurgenceWhat’sNew(1)Changeofriskclassificationandtuberculinskintest(TST)frequencyExpande

3、dscopeaddressinglab,outpatient,andnontraditionalsettingsExpandeddefinitionsofaffectedHCWs“TST”insteadof“PPD”What’sNew(2)QuantiFERON-TBGoldtest(QFT-G)QFT-GisatypeofbloodassayforM.tuberculosis(BAMT)Measuresthepatient’simmunesystemreactiontoM.tuberculosisBlo

4、odsamplesmustbeprocessedwithin12hoursInterpretationofQFT-Gresultsisinfluencedbythepatient’sriskforinfectionwithM.tuberculosisAnalternativetoTSTWhat’sNew(3)Term“airborneinfectionisolation”(AII)CriteriaforinitiatinganddiscontinuingAIIprecautionsRespiratorfi

5、ttestingandtraining;voluntaryuseofrespiratorsbyvisitorsAdditionalinformationonultravioletgermicidalirradiation(UVGI)Frequentlyaskedquestions(FAQs)ChangeinRiskClassificationsPreviousMinimalVerylowLowIntermediateHighNewLowMediumPotentialongoingtransmissionH

6、CWsWhoMayBeIncludedinaTBTestingProgramPaidandunpaidpersonsworkinginhealth-caresettingswhohavepotentialforexposuretoM.tuberculosisthroughsharedairspacewithinfectiouspatientIncludespart-time,full-time,temporary,andcontractstaffAllHCWswhosedutiesinvolveface

7、-to-facecontactwithsuspectedorconfirmedTBshouldbeinaTBscreeningprogramTransmissionofM.tuberculosisSpreadbyairborneroute;dropletnucleiTransmissionaffectedbyInfectiousnessofpatientEnvironmentalconditionsDurationofexposureMostexposedpersonsdonotbecomeinfecte

8、dTBPathogenesis(1)LatentTBInfectionOnceinhaled,bacteriatraveltolungalveoliandestablishinfection2–12wksafterinfection,immuneresponselimitsactivity;infectionisdetectableSomebacteriasurviveandremaindormantbutviablefory