Control of tuberculosis during aerosol therapy administration.
In summary, despite the major benefits conferred by aerosol therapy, the risk of transmission of M tuberculosis remains a concern. The most effective approach to preventing nosocomial transmission of respiratory infections such as tuberculosis is to prevent disease in patients at risk, particularly those receiving aerosol therapy. Tuberculin skin tests should be applied to all HIV-infected persons and chemoprophylaxis administered to those with greater than or equal to 5mm reaction. Early detection and treatment of tuberculosis are essential to prevent transmission both inside and outside of health-care settings. Cough-reduction measures should be taken when giving pentamidine aerosol, and patients who do cough should cover their mouths. Proper ventilation of treatment areas with negative air pressure and at least 10 air changes per hour, and more if feasible, is essential. HEPA filters should be installed to cleanse exhaust air from treatment rooms, and air should not be recirculated. The use of UV light to disinfect air is recommended only for special situations. Finally, personal protective devices should be worn by health-care workers who are exposed to patients receiving aerosol therapy when other measures do not offer adequate protection.
Chaisson
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Johns Hopkins University School of Medicine, Baltimore, MD.
McAvinue
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D000336:Aerosols / Q000009:adverse effects*; D003371:Cough / Q000139:chemically induced; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D015658:HIV Infections / Q000150:complications; D006801:Humans; D009330:Nebulizers and Vaporizers; D010419:Pentamidine / Q000009:adverse effects*; D010564:Personnel, Hospital / Q000592:standards; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy; D012138:Respiratory Therapy / Q000009:adverse effects*; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission; D014691:Ventilation / Q000295:instrumentation