Journal
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
Volume 23, Issue 4, Pages 465-473Publisher
INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
DOI: 10.5588/ijtld.18.0218
Keywords
indoor air; nosocomial transmission; real-time qPCR
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Funding
- Chulalongkorn University, Bangkok
- National Research Council of Thailand (NRCT), Bangkok, Thailand
- Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand [RA 2015/015]
- 90th Anniversary of Chulalongkorn University Fund [16]
- FY2016 Thesis Grant for a Doctoral Degree Student of the NRCT [1/19]
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SETTING : In high-risk areas (sputum collection room in a tuberculosis [TB] clinic, patient rooms in a TB ward, the emergency department and the bronchoscopy unit) in seven health care facilities located in central Thailand. OBJECTIVE : To detect airborne Mycobacterium tuberculosis complex and other environmental parameters using the liquid impinger and real-time quantitative polymerase chain reaction (real-time qPCR) technique in high-risk areas. DESIGN: Cross-sectional study. RESULTS : M. tuberculosis was detected in 3 of 99 (3.0%, 95% CI 0.6-8.6) areas: one sputum collection room and one TB in-patient room in one facility and one sputum collection room in another facility. In these three areas, the M. tuberculosis copy number/m(3) ranged from 9.6 to 1671. Lower air change rate (<6 h(-1)), higher relative humidity (>65%), and contact with coughing patient(s) were more common in airborne M. tuberculosis-positive areas than in M. tuberculosis-negative areas. CONCLUSIONS : Air sampling using a liquid impinger followed by real-time qPCR is effective for quantitative detection of airborne M. tuberculosis in high-risk areas. Our findings indicate TB risk among health care workers, and suggest that improved ventilation, enhanced appropriate cough etiquette and respiratory protection are needed to mitigate M. tuberculosis transmission.
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