Morbidity and Mortality Weekly Report, Volume 43, Number RR-13, October 28, 1994. Guidelines for Preventing the Transmission of 'Mycobacterium tuberculosis' in Health-Care Facilities, 1994

摘要

This document updates and replaces all previously published guidelines for the prevention of 'Mycobacterium tuberculosis' transmission in health-care facilities. The purpose of this revision is to emphasize the importance of a) the hierarchy of control measures, including administrative and engineering controls and personal respiratory protection; b) the use of risk assessments for developing a written tuberculosis (TB) control plan; c) early identification and management of persons who have TB; d) TB screening programs for health-care workers (HCWs); e) HCW training and education; and f) the evaluation of TB infection-control programs. Although completely eliminating the risk for transmission of M. tuberculosis in all health-care facilities may not be possible at the present time, adherence to these guidelines should reduce the risk to persons in these settings. Recently, nosocomial TB outbreaks have demonstrated the substantial morbidity and mortality among patients and HCW's that have been associated with incomplete implementation of CDC's Guidelines for Preventing the Transmission of Tuberculosis in Health-Care Facilities, with Special Focus on HIV-Related Issues published in 1990. Follow-up investigations at some of these hospitals have documented that complete implementation of measures similar or identical to those in the 1990 TB Guidelines significantly reduced or eliminated nosocomial transmission of M. tuberculosis to patients and/or HCWs.