Fraisse P
Service de Pneumologie, Hôpital de Hautepierre, Strasbourg, France.
Rev Mal Respir. 2005 Jun;22(3):431-47. doi: 10.1016/s0761-8425(05)85571-8.
The hospital is a favourable setting for the transmission of tubercle bacilli. The presence of susceptible subjects, often immunocompromised, increases the dangers. This risk extends to the patients' visitors and to the staff. It is therefore the responsibility of the hospital to establish preventative measures capable of reducing the risk of transmission or to reduce the effects by appropriate management of exposed subjects.
The modes and vectors of transmission are well established. The standardised prevention of transmission is achieved by isolation, the indications and duration of which are based on incomplete information. The surveillance of the carers by the doctor in charge, is based on precise recommendations depending on the risk of exposure.
The objectives are a reduction diagnostic delay, a better determination of infectivity and its duration during treatment, and a more complete census of cases of hospital acquired tuberculosis.
The management of tuberculosis in hospital requires co-ordination of all involved including those outside the institution and a deliberate policy in the institution itself.
医院是结核杆菌传播的有利场所。易感人群（通常免疫功能低下）的存在增加了风险。这种风险延伸至患者的访客和工作人员。因此，医院有责任制定能够降低传播风险的预防措施，或通过对暴露人群的适当管理来减轻影响。
传播方式和载体已明确。通过隔离实现标准化的传播预防，其指征和持续时间基于不完整的信息。主管医生对护理人员的监测基于根据暴露风险而定的精确建议。
目标是减少诊断延迟，更好地确定治疗期间的传染性及其持续时间，以及更全面地普查医院获得性结核病病例。
医院内结核病的管理需要所有相关方（包括机构外的人员）进行协调，并在机构内部制定深思熟虑的政策。
