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Depending on the procedural risk in the TB lab, the lab is classified into low, moderate and high-risk categories.

 

Low-risk TB laboratories work on sputum specimens for:

  1. Direct Acid-fast Bacilli (AFB) smear microscopy
  2. Cartridge-based Nucleic Acid Amplification Test (CBNAAT)/ Truenat

Figure 1: Procedures Conducted in a Low-Risk TB Lab

 

  • Procedures that involve direct microscopy or killing of the mycobacteria before microscopy are taken up in these labs.
  • These labs have a low risk of generating infectious aerosols from specimens and a low concentration of infectious particles.

 

Features and Essential Minimum Biosafety Measures of Low-risk TB Labs

 

1. Space requirements  

  • Bench spaces should be separated from areas used to receive specimens and administrative areas used for paperwork and telephones.
  • Ensure adequate ventilation; it is important to maintain natural or mechanical, directional airflow with 6-12 air changes per hour (ACH). Workstations are optional solutions.

2. Procedural requirements

To minimize the generation of aerosols:

  • Carefully open specimen containers.
  • Air-dry smears and use a flame to fix them.
  • Use disposable wooden sticks or transfer loops.

For the handling of leaking specimen containers: Discard and request a fresh sample.

 

3. Personal Protective Equipment (PPE) requirements

  • Protective laboratory coats should be worn at all times in the laboratory.
  • Gloves must be worn for all procedures that involve direct contact with potentially infectious materials.
  • Gloves should not be reused.
  • Staff should always wash their hands before leaving the laboratory.
  • Respirators are optional.

Figure 2: Challenges in a Low-risk TB Lab that Increase the Risk of Infection

 

 

Resources

 

 

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Dr. Priyadarshini Sun, 14/01/2024 - 13:19

Figure 1 doesn't seem relevant to the text or must be elaborated in the description. Figure 2 can be a separate slide