Hospital infection control in an era of HIV infection and multi-drug resistant tuberculosis

Tuberculosis infection control in hospitals has received renewed interest a fter decades of low prominence following the occurrence of multiply drug-re sistant strains in populations of patients with immune systems affected by HIV. This paper examines the history of tuberculosis infection control in h ospitals and how recent outbreaks have influenced contemporary measures. Th e prinicipal infection control measure must always be early recognition and isolation of patients in HIV-care situations who may be dispersing Mycobac terium tuberculosis, in both ward and outpatient areas. If there is either a high degree of suspicion or proven TB, patients should be housed in negat ive pressure isolation rooms whilst undergoing treatment and investigation. Procedures which may generate infectious aerosols should be carried out in similarly ventilated rooms. The quality assurance in such infection contro l is through the administrative systems put in place, staff training and th e engineering controls of isolation room ventilation. (C) 2000 The Hospital Infection Society.