Munsiff Sonal S, Nivin Beth, Sacajiu Galit, Mathema Barun, Bifani Pablo, Kreiswirth Barry N
Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, New York, New York 10013, USA.
J Infect Dis. 2003 Aug 1;188(3):356-63. doi: 10.1086/376837. Epub 2003 Jul 18.
One multidrug-resistant Mycobacterium tuberculosis (MDRTB) strain, strain W, caused several nosocomial outbreaks in New York City (NYC) during 1 January 1990-31 July 1993. We reviewed all MDRTB cases verified during 1 August 1993-31 December 1999 that had isolates with either this DNA pattern or a variant of this strain, and we compared them to the outbreak cases. Of 427 DNA-confirmed cases from 1990-1999, 161 (37%) were from 1 August 1993-31 December 1999; these 161 cases, from 56 hospitals and 2 correctional sites, constituted 28% of all MDRTB cases in NYC during this period. Compared with those from 1 January 1990-31 July 1993, patients from 1 August 1993-31 December 1999 were less likely to be infected with human immunodeficiency virus, to have been born in the United States, to be homeless, to have been incarcerated, and to have epidemiological links; 16% of patients had nosocomial- and 9% had community-exposure links. This strain was disseminated widely in the community during the outbreaks; postoutbreak cases likely represent reactivated disease among individuals infected during the outbreak periods in the community.
1990年1月1日至1993年7月31日期间，一株耐多药结核分枝杆菌（MDRTB）菌株W在纽约市（NYC）引发了几起医院感染暴发。我们回顾了1993年8月1日至1999年12月31日期间所有经DNA检测确诊的MDRTB病例，这些病例的分离株具有该DNA模式或该菌株的变体，并将它们与暴发病例进行比较。在1990 - 1999年427例经DNA确认的病例中，161例（37%）来自1993年8月1日至1999年12月31日；这161例病例来自56家医院和2个惩教场所，占该时期纽约市所有MDRTB病例的28%。与1990年1月1日至1993年7月31日的病例相比，1993年8月1日至1999年12月31日的患者感染人类免疫缺陷病毒的可能性较小，在美国出生的可能性较小，无家可归的可能性较小，被监禁的可能性较小，且有流行病学关联的可能性较小；16%的患者有医院感染关联，9%的患者有社区暴露关联。在暴发期间，该菌株在社区中广泛传播；暴发后病例可能代表在社区暴发期间感染的个体中重新激活的疾病。
