TAILIEUCHUNG - Chapter 125. Health Care– Associated Infections (Part 9)

Tuberculosis Important measures for the control of tuberculosis (Chap. 158) include prompt recognition, isolation, and treatment of cases; recognition of atypical presentations (., lower-lobe infiltrates without cavitation); use of negativepressure, 100% exhaust, private isolation rooms with closed doors and 6–12 or more air changes per hour; use of N95 "respirators" (approved by the National Institute for Occupational Safety and Health) by caregivers entering isolation rooms; possible use of high-efficiency particulate air filter units and/or ultraviolet lights for disinfecting air when other engineering controls are not feasible or reliable; and follow-up skin-testing of susceptible personnel who have been exposed to infectious. | Chapter 125. Health Care- Associated Infections Part 9 Tuberculosis Important measures for the control of tuberculosis Chap. 158 include prompt recognition isolation and treatment of cases recognition of atypical presentations . lower-lobe infiltrates without cavitation use of negativepressure 100 exhaust private isolation rooms with closed doors and 6-12 or more air changes per hour use of N95 respirators approved by the National Institute for Occupational Safety and Health by caregivers entering isolation rooms possible use of high-efficiency particulate air filter units and or ultraviolet lights for disinfecting air when other engineering controls are not feasible or reliable and follow-up skin-testing of susceptible personnel who have been exposed to infectious patients before isolation. The use of new serologic tests rather than skin tests in the diagnosis of latent tuberculosis for infection control purposes is being studied. Group a Streptococcal Infections The potential for an outbreak of group A streptococcal infection Chap. 130 should be considered when even a single nosocomial case occurs. Most outbreaks involve surgical wounds and are due to the presence of an asymptomatic carrier in the operating room. Investigation can be confounded by carriage at extrapharyngeal sites such as the rectum and vagina. Health care workers in whom carriage has been linked to nosocomial transmission of group A streptococci are removed from the patient-care setting and are not permitted to return until carriage has been eliminated by antimicrobial therapy. Fungal Infections Fungal spores are common in the environment particularly on dusty surfaces. When dusty areas are disturbed during hospital repairs or renovation the spores become airborne. Inhalation of spores by immunosuppressed especially neutropenic patients creates a risk of pulmonary and or paranasal sinus infection and disseminated aspergillosis Chap. 197 . Routine surveillance among neutropenic patients for .

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