FitzGerald J M, Fanning A, Hoepnner V, Hershfield E, Kunimoto D
Division of Tuberculosis Control, British Columbia Centres for Disease Control (BCCDC), Center for Clinical Epidemiology and Evaluation, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Int J Tuberc Lung Dis. 2003 Feb;7(2):132-8.
To define the molecular epidemiology of TB in western Canada, and in particular the risk factors for clustering.
We prospectively identified all positive cultures from newly diagnosed cases of TB diagnosed between February 1995 and January 1997 and carried out restriction fragment length polymorphism (RFLP) testing on all isolates.
Of 956 cases identified, 944 fulfilled the entry criteria. The mean age was 49.65 years (+/- 22.33), and 508 (53.6%) were males. Three hundred and three (32.1%) subjects were clustered; this varied from 20.2% of the foreign born, 48.4% of Canadian non-Aboriginal and 61.1% of all Aboriginal persons. Younger persons (P = 0.0001), males (P = 0.015), those with pulmonary disease (P < 0.001), living in a shelter in the past year (P < 0.001), drug-susceptible disease (P < 0.036), predisposing factors (P < 0.001), prior contact (P < 0.001), and prior skin test (P < 0.002) were more likely to cluster. Among specific risk factors, HIV infection, injection drug use, alcohol excess, and weight loss were all significant.
In this description of the molecular epidemiology of TB in Western Canada, previous results have been confirmed and extended. These results highlight the importance of identifying specific high risk groups, especially in the context of renewed efforts to target persons for treatment of latent TB infection.
确定加拿大西部结核病的分子流行病学，尤其是聚集性的危险因素。
我们前瞻性地识别了1995年2月至1997年1月期间新诊断出的所有结核病病例的阳性培养物，并对所有分离株进行了限制性片段长度多态性（RFLP）检测。
在识别出的956例病例中，944例符合纳入标准。平均年龄为49.65岁（±22.33），508例（53.6%）为男性。303例（32.1%）受试者存在聚集现象；这在外国出生者中占20.2%，加拿大非原住民中占48.4%，所有原住民中占61.1%。年轻人（P = 0.0001）、男性（P = 0.015）、患有肺部疾病者（P < 0.001）、过去一年居住在收容所者（P < 0.001）、药物敏感疾病患者（P < 0.036）、易感因素者（P < 0.001）、有过接触者（P < 0.001）和有过结核菌素皮肤试验者（P < 0.002）更有可能出现聚集现象。在特定危险因素中，HIV感染、注射吸毒、酗酒和体重减轻均具有统计学意义。
在对加拿大西部结核病分子流行病学的描述中，先前的结果得到了证实和扩展。这些结果凸显了识别特定高危人群的重要性，尤其是在重新努力针对潜伏性结核感染人群进行治疗的背景下。
