TY - JOUR T1 - Protection of healthcare workers against transmission of <em>Mycobacterium tuberculosis</em> in hospitals: a review of the evidence JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00317-2019 VL - 6 IS - 1 SP - 00317-2019 AU - Roland Diel AU - Albert Nienhaus AU - Peter Witte AU - Renate Ziegler Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/6/1/00317-2019.abstract N2 - Background Employees in contact with infectious tuberculosis (TB) patients in healthcare facilities of low-incidence countries are still at considerable risk of acquiring TB infections. However, formal precautions recommended on the protection of healthcare workers may not only vary from country to country but also within a single country. The objective of this study was to compare current guidelines with respect to hospital infection control of TB, focusing on common shared priorities and discrepancies between sets of recommendations.Methods Five types of procedures captured in guidelines of the World Health Organization, the United States of America, the United Kingdom and Germany are compared and the underlying evidence is discussed.Results Uncontroversially, personal protection by respirators in the TB ward and during aerosol-generating procedures is key to reducing Mycobacterium tuberculosis exposure. However, there is no consensus on the types of masks that should be worn in different situations. Closely connected to this, there is considerable uncertainty with respect to the optimal date of removing sputum smear-negative and multidrug-resistant TB patients from isolation. Indeed, the use of notable new tools for this purpose, such as the highly sensitive PCR tests recommended by the World Health Organization for detecting TB/multidrug-resistant TB, have yet to be sufficiently incorporated into TB guidelines. Perceptions differ, too, as to whether long-term control measures for M. tuberculosis infections in healthcare workers by serial testing for latent TB infection should be established and, if so, how testing results should be interpreted.Conclusions Although the current recommendations on protection of healthcare workers are otherwise homogeneous, there are considerable discrepancies that have important implications for daily practice.Current @WHO, US, UK and German recommendations on protecting employees in healthcare facilities against M. tuberculosis transmission show considerable practical discrepancies. Harmonisation and practical amendments of such guidelines is most desirable. http://bit.ly/2EzGlBN ER -