Pilot study to detect airborne Mycobacterium tuberculosis exposure in a South African public healthcare facility outpatient clinic

O Matuka; T S Singh; E Bryce; A Yassi; O Kgasha; M Zungu; K Kyaw; M Malotle; K Renton; L O'Hara

doi:10.1016/j.jhin.2014.11.013

Pilot study to detect airborne Mycobacterium tuberculosis exposure in a South African public healthcare facility outpatient clinic

J Hosp Infect. 2015 Mar;89(3):192-6. doi: 10.1016/j.jhin.2014.11.013. Epub 2014 Dec 27.

Authors

O Matuka¹, T S Singh², E Bryce³, A Yassi⁴, O Kgasha⁵, M Zungu⁶, K Kyaw⁵, M Malotle⁵, K Renton⁵, L O'Hara⁴

Affiliations

¹ National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, University of Witwatersrand, Johannesburg, South Africa.
² National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, University of Witwatersrand, Johannesburg, South Africa. Electronic address: [email protected].
³ Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
⁴ School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
⁵ National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.
⁶ National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa; Department of Public Health Medicine, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.

PMID: 25623206
DOI: 10.1016/j.jhin.2014.11.013

Abstract

Background: Airborne transmission of Mycobacterium tuberculosis remains an occupational health hazard, particularly in crowded and resource-limited healthcare settings.

Aim: To quantify airborne M. tuberculosis in a busy outpatient clinic in Gauteng, South Africa.

Methods: Stationary air samples and samples from healthcare workers (HCWs) were collected in the polyclinic and administrative block. Quantitative real-time polymerase chain reaction (PCR) was used to detect airborne M. tuberculosis. Walkthrough observations and work practices of HCWs were also recorded.

Findings: In total, M. tuberculosis was detected in 11 of 49 (22.4%) samples: nine of 25 (36%) HCW samples and two of 24 (8.3%) stationary air samples. Samples from five of 10 medical officers (50%) and three of 13 nurses (23%) were positive. Repeat measurements on different days showed variable results. Most of the HCWs (87.5%) with positive results had been in contact with coughing patients and had not worn respiratory masks despite training.

Conclusion: The use of air sampling coupled with quantitative real-time PCR is a simple and effective tool to demonstrate the risk of M. tuberculosis exposure. The findings provide an impetus for hospital management to strengthen infection prevention and control measures for tuberculosis.

Keywords: Air sampling; Healthcare workers; Infection prevention and control; Occupational exposure; Polymerase chain reaction; Tuberculosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Microbiology*
Air Pollution, Indoor / analysis
Ambulatory Care Facilities / standards
Cross Infection / microbiology
Cross Infection / prevention & control
DNA, Bacterial / analysis
Environmental Monitoring / methods
Female
Health Personnel
Humans
Infectious Disease Transmission, Patient-to-Professional*
Male
Mycobacterium tuberculosis / isolation & purification*
Occupational Exposure / analysis*
Pilot Projects
Real-Time Polymerase Chain Reaction / methods
South Africa
Tuberculosis / microbiology
Tuberculosis / prevention & control
Tuberculosis / transmission

Substances

DNA, Bacterial

Abstract

Publication types

MeSH terms

Substances

Grants and funding