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[结核病感染控制——德国中央卫生委员会的建议]

[Tuberculosis infection control--recommendations of the DZK].

作者信息

Ziegler R, Just H-M, Castell S, Diel R, Gastmeier P, Haas W, Hauer B, Loytved G, Mielke M, Moser I, Nienhaus A, Richter E, Rüden H, Rüsch-Gerdes S, Schaberg T, Wischnewski N, Loddenkemper R

机构信息

Institut für Klinikhygiene, Med. Mikrobiologie u. Klin. Infektiologie, Klinikum Nürnberg, Germany.

出版信息

Pneumologie. 2012 May;66(5):269-82. doi: 10.1055/s-0031-1291582. Epub 2012 Jan 31.

Abstract

The epidemiological situation of tuberculosis (TB) in Germany has improved considerably during the past few years. However, those in unprotected contact with infectious tuberculosis patients frequently and/or over longer periods of time and/or intensively continue to have a higher risk for TB infection. Rapid diagnosis, prompt initiation of effective treatment, and adequate infection control measures are of particular importance to prevent infection. The present recommendations depict the essentials of infection control as well as specific measures in the hospital (isolation, criteria for its duration and technical requirements, types of respiratory protection, disinfection measures, waste disposal). The specific requirements for outpatients (medical practice), at home, for ambulance services, and in congregate settings, including prisons, are also addressed. Compared with the previous recommendations the pattern of respiratory protection measures has been simplified. As a rule, hospital staff and those visiting infectious tuberculosis patients are advised to wear respiratory protection that satisfies the criteria of FFP2-masks (DIN EN 149), while patients should wear mouth-nose protectors (surgical masks) in the presence of others and outside the isolation room. A detailed depiction of criteria for isolation and its duration in smear positive and only culturally confirmed pulmonary tuberculosis has been added.

摘要

在过去几年中,德国的结核病流行病学状况有了显著改善。然而,那些经常和/或长时间和/或密切接触传染性结核病患者的人,感染结核病的风险仍然较高。快速诊断、及时开始有效治疗以及适当的感染控制措施对于预防感染尤为重要。本建议阐述了感染控制的要点以及医院中的具体措施(隔离、隔离持续时间的标准和技术要求、呼吸防护类型、消毒措施、废物处理)。还讨论了门诊(诊所)、家庭、救护车服务以及包括监狱在内的集体场所的具体要求。与先前的建议相比,呼吸防护措施的模式已经简化。通常,建议医院工作人员和探视传染性结核病患者的人员佩戴符合FFP2口罩标准(DIN EN 149)的呼吸防护用品,而患者在他人面前以及在隔离病房外时应佩戴口鼻防护器(外科口罩)。增加了涂片阳性和仅培养确诊的肺结核的隔离标准及其持续时间的详细描述。

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