From the Guidelines
Active Tuberculosis (TB) precautions are crucial to prevent transmission and require a combination of administrative, engineering, and personal protective measures.
Key Precautions
- Isolation: Patients with active TB should be isolated, preferably in a negative pressure room, until the risk of transmission is reduced to very low levels and adequate treatment supervision measures are in place 1.
- Personal Respiratory Protection: Healthcare workers (HCWs) should use personal respiratory protection when entering rooms of patients with known or suspected infectious TB, during cough-inducing or aerosol-generating procedures, and in other settings where administrative and engineering controls are not likely to protect them from inhaling infectious airborne droplet nuclei 1.
- Infection Control Measures: Comprehensive infection-control measures should be used to reduce the risk for M. tuberculosis transmission, including prompt identification, isolation, and treatment of persons who have active TB disease 1.
- Screening and Diagnostic Services: Patients should be screened for active tuberculosis and tuberculous infection, and rapid diagnostic services should be provided to ensure prompt identification and treatment of TB cases 1.
- Respiratory Containment: Patients with suspected or confirmed infectious TB should be instructed to cover their mouths and noses with a tissue when coughing or sneezing, and HCWs should wear respiratory protection when entering these patients' homes until they are no longer infectious 1.
Additional Considerations
- Negative Pressure Isolation Rooms: While ideal, negative-pressure isolation rooms may not be available in resource-limited settings and are a limited resource even in industrialized countries 1.
- Balancing Patient Harms and Healthcare Costs: The balance between potential patient harms and healthcare costs from unnecessary isolation should be carefully considered to ensure rational utilization of limited isolation rooms 1.
From the Research
Precautions for Active Tuberculosis (TB)
To prevent the transmission of active Tuberculosis (TB), several precautions can be taken, including:
- Isolating suspected and confirmed TB cases in a negative pressure room 2
- Using respirator masks to prevent the spread of TB 2, 3
- Limiting interpersonal contacts with TB patients 2
- Implementing airborne precautions, such as using personal respiratory protection for healthcare workers who are exposed to TB in patient care 3, 4, 5
- Conducting early recognition of potentially infectious cases and prompt medical treatment of cases 3
- Providing standard precautions, combining major features of universal precautions, body substance isolation, and air-borne precautions 4
Infection Control Measures
Infection control measures to reduce TB transmission consist of:
- Managerial activities 6
- Administrative control 4, 6, 5
- Engineering control 4, 6
- Environmental control 4, 6, 5
- Personal protective equipment provision 4, 6, 5
Risk Reduction Strategies
Strategies to reduce the risk of TB transmission in healthcare settings include:
- Having an operational TB infection control plan that emphasizes the use of a hierarchy of controls (administrative, environmental, and personal respiratory protection) 5
- Early diagnosis and treatment of TB cases 3, 6
- Investigating non-compliance with airborne precautions and establishing exhaustive lists of potentially exposed healthcare workers and patients 3