Author: Joel Dombrowski
Position: Marketing Director
Institution: VIGILAIR Systems, Inc.
E-mail: joel.dombrowski@vigilairsystems.com
Submitted Date: January 23, 2007
Published Date: January 23, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Congratulations on a well written, topical article that approaches XDR-TB in a balanced manner. So much of the interest in XDR-TB focuses on treatment of infected patients. What about infection prevention?
It appears as if prevention methods could yield immediate and long term cost effective results.
TB was virtually eliminated from the US thanks to a spectrum approach that included the use of ultraviolet germicidal irradaition (UVGI) in hospitals, TB wards, homeless shelters, etc.
Immediately implementing UVGI, negative pressure rooms and other environmental controls would aid in stopping the nosocomial spread of TB to patients and healthcare workers alike.
Installation of upper air UVGI systems in appropriate public gathering places would help reduce TB in the long term.
Environmental controls are not a cure-all, and may be unrealistic for some poverty stricken areas. But in the hospital setting especially, such measures are safe, effective, inexpensive and easy to maintain.
While new antibiotics play a vital role in the fight, it is likely that TB will change to render these weapons ineffective. Irradiation of pathogens does not lead to this cycle, but rather breaks the chain of transmission.
Environmental controls could help decrease the need for involuntary isolation.