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Canada Communicable Disease Report

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Volume: 22S1 • April 1996

Guidelines for Preventing the Transmission of Tuberculosis in Canadian Health Care Facilities and Other Institutional Settings

VI. LABORATORIES

Specific details related to laboratories performing diagnostic or research activities on mycobacteria are beyond the scope of this document. Please refer to the Laboratory Biosafety Guidelines, a publication of Health and Welfare Canada and the Medical Research Council of Canada [Supply and Services Canada, 1990 (Cat. No. MR 21-1/1990E)]. Personnel responsible for the laboratory component of the TB program should ensure that the TB program is integrated into the organization's laboratory quality control program.

Laboratory Identification of M. tuberculosis

The Laboratory Biosafety Guidelines classify M. tuberculosis as a Risk Group 3 pathogen(55).

Tubercle bacilli may be present in sputum, gastric lavage fluids, cerebrospinal fluid, urine and a variety of tissues, as well as in heat-fixed smears(75). Exposure to respirable aerosols generated by various laboratory manipulations presents the greatest hazard to laboratory staff. Because of the low infective dose of M. tuberculosis for humans (< 10 ID50(75,85)), all clinical specimens from persons with suspected or confirmed TB must be considered potentially infectious. All laboratory staff must be fully trained in appropriate handling and manipulation of these materials.

Operational and Physical Requirements

  • Containment level 2 practices, equipment and facilities are required for the preparation of smears and primary culturing of sputa and other clinical specimens provided that such procedures are conducted in a tested and certified class I or II biologic safety cabinet.
  • Containment level 3 practices, equipment and facilities are required for the propagation and manipulation of cultures of M. tuberculosis, susceptibility testing, identification of non-tuberculosis, mycobacteria, reference, research and animal studies.
  • Laboratory personnel must be included in the facility HCW screening and surveillance programs (see Section IV.C).

 

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