[Hospital infection control practice for tuberculosis]

Abstract

In Japan, annual incidence rate of tuberculosis was 31.0/10,000 population in 2000. But that of some hot spots, such as Osaka prefecture(61.5/10,000), were still high. Hospital infection control practice for tuberculosis in such a endemic area was discussed in this review. The tuberculosis infection-control program should be based on a hierarchy of control measures. The first level was local control practice in the area, the second level was administrative controls in the hospital, the third level was engineering control to prevent the spread of infectious doplet nuclei, and the fourth level was personal protection, such as N95 respirators. Because of general vaccination policy with BCG, detection of persons infected by M. tuberculosis were rather difficult in Japan, by using tuberculin skin test. In such a circumstance, how to select health care workers to whom chemoprophylaxis with isoniazid should be administered was also discussed.