Bauer J, Kok-Jensen A, Faurschou P, Thuesen J, Taudorf E, Andersen A B
Department of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.
Int J Tuberc Lung Dis. 2000 Apr;4(4):295-9.
Denmark, a country with a low incidence of tuberculosis (TB).
To evaluate the value of the nation-wide DNA fingerprinting of Mycobacterium tuberculosis isolates performed in Denmark since 1992.
Prospective study of consecutive patients with culture-verified TB from five large TB Departments in Denmark during a 7-month period in 1998. Results of IS6110 RFLP and spoligotyping were compared to those in the nation-wide Danish DNA-fingerprint database which covers approximately 95% of all culture-verified TB cases from 1992 onwards. Questionnaires asking about contact tracing and epidemiological links were sent to the patients' treating physicians.
Of the 177 patients included in the study, 57 were Danes, one was from Iceland, 111 were immigrants, and eight were from Greenland. Responses to the questionnaires were obtained from 163 patients (92%). Four cases of unsuspected transmission were detected: one of nosocomial spread of TB, one of occupational acquisition of TB and two of transmission in an international school, leading to further contact tracing among 75 schoolchildren. These four cases were all the result of short-term contacts. In 22 cases, contact with one or more TB patient(s) was reported. In six of these, the DNA-fingerprint result revealed that the presumed contact could not be the source of infection, even though in two of the cases the known TB contact was from the household.
Nation-wide DNA fingerprinting of TB isolates provides information that could not have been obtained otherwise, and contribute to the understanding of TB transmission in Danish society. In some cases the results lead to further contact tracing. Short-term contact can apparently result in transmission of TB.
丹麦是一个结核病（TB）发病率较低的国家。
评估自1992年以来在丹麦对结核分枝杆菌分离株进行全国性DNA指纹识别的价值。
对1998年7个月期间丹麦五个大型结核病科室经培养确诊为结核病的连续患者进行前瞻性研究。将IS6110限制性片段长度多态性（RFLP）和间隔寡核苷酸分型（spoligotyping）的结果与丹麦全国性DNA指纹数据库中的结果进行比较，该数据库涵盖了自1992年起约95%的经培养确诊的结核病病例。向患者的主治医生发送了关于接触者追踪和流行病学联系的调查问卷。
纳入研究的177名患者中，57名是丹麦人，1名来自冰岛，111名是移民，8名来自格陵兰。收到了163名患者（92%）对调查问卷的回复。检测到4例未被怀疑的传播病例：1例为医院内结核病传播，1例为职业性感染结核病，2例为在一所国际学校内传播，导致对75名学童进行了进一步的接触者追踪。这4例均为短期接触的结果。22例患者报告与1名或多名结核病患者有接触。其中6例中，DNA指纹结果显示，即使在2例中已知的结核病接触者来自同一家庭，推测的接触者也不可能是感染源。
对结核病分离株进行全国性DNA指纹识别可提供通过其他方式无法获得的信息，并有助于了解丹麦社会中的结核病传播情况。在某些情况下，结果会导致进一步的接触者追踪。短期接触显然可导致结核病传播。
