Healthcare visits of HIV-infected persons before and after tuberculosis diagnosis and contamination of the environment of health-care facilities with mycobacterium tuberculosis

The objective. To study healthcare visits of HIV-infected persons before and after they were diagnosed with tuberculosis and contamination of healthcare facilities (HF) with mycobacterium tuberculosis. Materials and methods. We studied medical records of 169 HIV-infected patients who fell ill with tuberculosis. The frequency of visits of HIV-infected patients to various HF before and after tuberculosis diagnosis was determined. Molecular-genetic examination of 316 smears was performed for the presence of mycobacterium tuberculosis (MBT) DNA, taken from the working environment of four HF (AIDS Centre clinic, infectious inpatient hospital for HIV-infected persons, tuberculosis inpatient clinic, local general-duty polyclinic). Results. As has been found, before and after tuberculosis diagnosis HIV-infected persons most commonly apply for medical aid to the AIDS Centre polyclinic, more rarely to other HF. Tuberculosis in HIV-infected persons is most commonly diagnosed in the AIDS Centre polyclinic, more rarely in general-duty polyclinic, department of the infectious hospital for HIV-infected patients, somatic and surgical inpatient units. According to molecular-genetic examination of environmental smear sampling in various healthcare facilities, the maximal contamination with MBT DNA was found in the AIDS Centre polyclinic, in a less degree in the tuberculosis inpatient hospital and the infectious inpatient hospital for HIV-infected persons. In the general-duty polyclinic, no mycobacterium tuberculosis DNA was isolated. Conclusion. Predominant visits of HIV-infected persons before and after tuberculosis diagnosis to the AIDS Centre polyclinic and a higher level of contamination of healthcare environment in this facility with MBT DNA show that in the settings of a specialised polyclinic there are conditions for nosocomial infection with tuberculosis bacteria.