Which airborne precautions and PPE are required for suspected active tuberculosis, and what are the room requirements?

• A. Droplet precautions; private room; surgical mask for staff.
• B. Contact precautions; standard room; gloves and gown.
• C. Airborne precautions; negative-pressure isolation room; fit-tested N95 respirator or PAPR for staff; patient wears a mask when outside the room.
• D. Airborne precautions; positive-pressure room; N95 respirator for staff only.

Answer: (C)

TB spreads through airborne particles, so preventing transmission requires airborne precautions rather than droplet or contact measures. The patient should be placed in a negative-pressure isolation room, which keeps room air at a lower pressure than surrounding areas so contaminants flow into the room and are exhausted rather than leaking out. The room needs adequate ventilation—typically at least 6 to 12 air changes per hour—and the door should remain closed to maintain the negative pressure. Ideally, the room exhausts to the outside or passes through appropriate filtration to prevent recirculation. Healthcare staff must wear a fit-tested N95 respirator or a powered air-purifying respirator when entering the room, with eye protection as indicated, and the patient should wear a mask whenever they leave the room to reduce the spread of infectious aerosols.