BMJ 1995;310:401 (11 February)

Letters

Transmission of tuberculosis in patients with HIV infection

EDITOR,--We agree with the final conclusions drawn by G M Scott and J Holton that even more strict controls should be adopted to control the transmission of tuberculosis in centres caring for patients with HIV infection.1 Transmission of tuberculosis at their hospital is, however, supported by both our molecular biology data and the epidemiology.

Editorial constraints prevented us from including detailed epidemiology of transmission in our paper.2 In Scott and Holton's investigation, apart from the patient in case 1 walking through Ward B, there were other potential exposures. Previous sputum smear tests in the patient had yielded positive results and he did not begin to receive antituberculosis treatment for several hours after bronchoscopy. Bronchoscopy induces coughing and formation of droplet nuclei. At the time of the potential outbreak of tuberculosis the room had an extractor fan venting separately from the ward but no negative pressure ventilation. The bronchoscopy room opens . . . [Full text of this article]


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