Munckhof W J, Konstantinos A, Wamsley M, Mortlock M, Gilpin C
Infection Management Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Int J Tuberc Lung Dis. 2003 Sep;7(9):860-5.
New cases of pulmonary tuberculosis (TB) were noted in a cluster of young Caucasian males, an unusual ethnic group for this disease in Queensland, Australia. It was noted that marijuana water pipe ('bong') smoking was common amongst cases and contacts.
To report this cluster of TB and to investigate whether shared use of a marijuana water pipe was associated with transmission of TB.
All contacts were identified and screened according to standard protocols. Cases were asked to list contacts with whom they had shared a marijuana water pipe.
Five cases of open pulmonary TB were identified clinically and on sputum culture, and all isolates of Mycobacterium tuberculosis were identical on typing. Of 149 contacts identified, 114 (77%) completed screening, and 57 (50%) had significant tuberculin skin test (TST) reactions on follow-up. Of 45 contacts who had shared a marijuana water pipe with a case, 29 (64%) had a significant TST reaction.
Sharing a marijuana water pipe with a case of pulmonary TB was associated with transmission of TB (OR 2.22, 95 % CI 0.96-5.17), although the most important risk factor for acquiring TB infection in this cluster was close household contact with a case (OR 4.91, 95% CI 1.13-20.70).
在一群年轻的白种男性中发现了新的肺结核病例，在澳大利亚昆士兰州，这是一个患这种疾病的不寻常种族群体。据注意到，吸食大麻水烟筒（“水烟枪”）在病例及其接触者中很常见。
报告这起肺结核病例群，并调查共用大麻水烟筒是否与结核病传播有关。
根据标准方案识别并筛查所有接触者。要求病例列出与他们共用过大麻水烟筒的接触者。
临床上和痰培养中确诊了5例开放性肺结核病例，所有结核分枝杆菌分离株在分型上均相同。在识别出的149名接触者中，114名（77%）完成了筛查，57名（50%）在随访时有显著的结核菌素皮肤试验（TST）反应。在与病例共用过大麻水烟筒的45名接触者中，29名（64%）有显著的TST反应。
与肺结核病例共用大麻水烟筒与结核病传播有关（比值比2.22，95%可信区间0.96 - 5.17），尽管在这起病例群中获得结核感染的最重要危险因素是与病例密切的家庭接触（比值比4.91，95%可信区间1.13 - 20.70）。
