The exposure assessment of Mycobacterium tuberculosis1.The concentration of Airborne Mycobacterium tuberculosis Profile in a hospital2. The Mycobacterium tuberculosis concentration of the patients breath and cough

• Main Authors: Tai-Wei Chen, 陳岱煒
• Other Authors: Pei-Shih Chen
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/h85daj

碩士 === 高雄醫學大學 === 公共衛生學研究所碩士班 === 95 === Aim: This research is for the purpose of applying filter/real-time the qPCR to understand the distribution of Mycobacterium tuberculosis in the infective area, the high risk area, the low risk area in the hospital, and discuss tuberculosis patient its breath and cough discharges concentration of the Mycobacterium tuberculosis. Method: To be aimed at the outbreak area : Chest cavity branch and infection branch hospital ward, the high risk area : the negative pressure isolation ward, the chest cavity branch and the infection branch examine with waits to see the doctor the area, as well as ophthalmology department of hospital ward, pediatrics the low risk respectively examine, waits to see the doctor the area to carry on the air sampling, carries on the patient who in the negative pressure isolation ward to exhale the gas and the cough priming sampling of, after carries on the DNA extract, and carries on the quantitative analysis by real-time qPCR. Result: In the hospital air the Mycobacterium tuberculosis masculine positive rate is 6.25%, all belongs to in the courtyard to infect chest cavity of and the infection branch hospital ward the region, the concentration range is 54~1109 copies/m3, the greatest concentration appears in the nursing station of the chest cavity branch. After the nursing station of the chest cavity branch air conditioning improvement, then not detects the Mycobacterium tuberculosis, also it’s bacterium concentration also reveals is reducing (p = 0.010). In the air the Mycobacterium tuberculosis existence place, the bacterium density can be higher. May the culture of bacteria density be partial in the air, altogether has 122 samples bacteria concentration to surpass room of in the environmental protection bureau announcement the air quality suggestion value draft suggestion value, the failure rate is 64%, but the fungus the failure rate is 8%. The nursing station of the chest cavity branch bacterium concentration around all not to conform to room of in the environmental protection bureau announcement in the air conditioning improvement the air quality suggestion value. In exhales the gas and the cough priming part, the patient coughs masculine positive rate of the sample is 43% (12,/28), masculine positive rate of the breath sample is 21.5% (6,/28), looked by the present result, cough sample test method sensitivity better, also phlegm of fluid raise and the acid resisting mirror the patient examine finally if all presents time the negative, result of the this research all presents the negative, represents this research the specificity to be good. Conclusion: This research by filter/real-time the qPCR method confirmed in the outbreak area in the air that have the existence Mycobacterium tuberculosis, in the hospital looked examines the region not to survey the Mycobacterium tuberculosis of existence. Is exhaling the gas and the cough priming part, discovered also may detect the bacillus tuberculosis using filter/real-time qPCR the density, also the patient coughs the sensitivity comparatively to breathe high, the patient accepts to be also higher.