Rubinstein Uri, Schachter Jacob, Sharon Nehama, Talnir Ruth, Amir Jacob
Department of Pediatrics, Laniado Hospital, Netanya, Israel.
Harefuah. 2007 Mar;146(3):170-2, 248.
Tuberculosis is still one of the most prevalent infectious diseases worldwide with a high annual morbidity and mortality rate. Its mode of spread necessitates prompt investigation to identify those with active disease, possible carriers and as many contacts as possible. This article describes a pair of twins with endobronchial tuberculosis following close contact with a family relative who had active disease. Mycobacterium tuberculosis was isolated from the family relative and the two children. Laboratory diagnosis of the mycobacterial strain and epidemiologic follow-up were performed using a molecular biology tool, the restriction fragment length polymorphism method. Treatment was successful due to the close cooperation between the medical staff of the hospitals, the community clinics and the Center for Diagnosis and Treatment of Tuberculosis. Treatment was administered by the directly observed therapy (DOT) method recommended by the World Health Organization. This article describes the clinical course and treatment of the patients and reviews the new molecular biology methods currently being used for the diagnosis of tuberculosis and their important clinical applications.
结核病仍然是全球最普遍的传染病之一，年发病率和死亡率都很高。其传播方式需要迅速展开调查，以确定患有活动性疾病的患者、可能的携带者以及尽可能多的接触者。本文描述了一对双胞胎在与一名患有活动性疾病的亲属密切接触后患上支气管内膜结核的情况。从该亲属和这两个孩子身上分离出了结核分枝杆菌。使用分子生物学工具——限制性片段长度多态性方法对分枝杆菌菌株进行了实验室诊断并开展了流行病学随访。由于医院医护人员、社区诊所和结核病诊断与治疗中心之间的密切合作，治疗取得了成功。治疗采用了世界卫生组织推荐的直接观察治疗（DOT）方法。本文描述了患者的临床病程和治疗情况，并综述了目前用于结核病诊断的新分子生物学方法及其重要的临床应用。
