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结核病:口腔医护人员的感染控制/暴露控制问题

Tuberculosis: infection control/exposure control issues for oral healthcare workers.

作者信息

Porteous Nuala B, Terezhalmy Geza T

机构信息

Department of Dental Diagnostic Science, the University of Texas Health Science Center at San Antonio, TX, USA.

出版信息

J Contemp Dent Pract. 2008 Jan 1;9(1):1-13.

Abstract

AIM

The aim is to present the essential elements of an infection control/exposure control plan for the oral healthcare setting with emphasis on tuberculosis (TB).

METHODS AND MATERIALS

A comprehensive review of the literature was conducted with special emphasis on TB infection-control issues in the oral healthcare setting.

RESULTS

Currently available knowledge related to TB infection-control issues is supported by data derived from well-conducted trials or extensive controlled observations. In the absence of supportive data the information is supported with the best-informed, most authoritative opinion available.

CONCLUSION

Essential elements of an effective TB infection-control plan include a three-level hierarchy of administrative, environmental, and respiratory-protection controls.

CLINICAL SIGNIFICANCE

Standard precautions provide the fabric for strategies to prevent or reduce the risk of exposure to bloodborne pathogens and other potentially infectious material. However, standard precautions are inadequate to prevent the spread of organisms through droplet nuclei 1-5 micron in diameter and additional measures are necessary to prevent the spread of Mycobacterium tuberculosis. Oral healthcare settings have been identified as outpatient settings in which patients with suspected or confirmed infectious TB disease are expected to be encountered. Therefore, oral healthcare settings must have a written TB infection-control program.

摘要

目的

旨在介绍口腔医疗机构感染控制/暴露控制计划的基本要素,重点关注结核病(TB)。

方法与材料

对文献进行全面综述,特别强调口腔医疗机构中的结核病感染控制问题。

结果

目前有关结核病感染控制问题的现有知识得到了来自精心设计的试验或广泛对照观察的数据支持。在缺乏支持性数据的情况下,信息以现有最明智、最权威的意见为依据。

结论

有效的结核病感染控制计划的基本要素包括行政、环境和呼吸防护控制三个层面的层级体系。

临床意义

标准预防措施为预防或降低接触血源性病原体和其他潜在感染性物质风险的策略提供了框架。然而,标准预防措施不足以防止直径为1 - 5微米的飞沫核传播病原体,需要采取额外措施来防止结核分枝杆菌的传播。口腔医疗机构已被确定为可能会遇到疑似或确诊感染性结核病患者的门诊机构。因此,口腔医疗机构必须有书面的结核病感染控制计划。

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