[New insights into transmission of tuberculosis].

INTRODUCTION: Considering the fact that tuberculosis is a global problem, that one third of the world population is infected with tuberculosis and that 8-10 million of newly recognized cases are detected per year, the need for acquiring new knowledge on pathogenesis and transmission of tuberculosis becomes obvious. Application of molecular biology methods in clinico-epidemiology practice has identified transmission chain of tuberculous bacilli in numerous intrahospital outbreaks of tuberculosis. CONDITIONS FAVORING TRANSMITION OF TUBERCULOUS: The possibility of transmission primarily depends on the following conditions: contagiousness of the patient who is a source of infection, conditions in which the exposure takes place, length of exposure, as well as the immune status of the exposed individual. RISK FACTORS FOR TRANSSMITION OF TUBERCULOSIS: Unrecognized, i.e., untreated tuberculosis represents a major risk factor for environmental spread of the bacillus. Therefore, early diagnosis and initiation of adequate therapy are priority tasks. High risk of tuberculous bacilli transmission is associated with all diagnostic and therapeutic procedures inducing cough, such as bronchoscopy, endotracheal intubation, induction of sputum, inhalation therapy as well as work in microbiological laboratories dealing with identification of M tuberculosis.

DISCUSSION: Results of numerous studies indicate that there is significant risk for transmission and infection of individuals exposed to the source of infection in family settings, work environment or other close contacts. The problem of exposure of health workers at their workplaces represents a problem in institutions dealing with diagnosis and treatment of tuberculosis.

CONCLUSION: A more comprehensive insight into significance of the problem and application of measures aimed at preventing transmission of tuberculosis should lead to practical application of preventive measures proposed by the International Union Against Tuberculosis and Lung Disease, in both hospital and non-hospital environments.