Cvetnic Z, Katalinic-Jankovic V, Sostaric B, Spicic S, Obrovac M, Marjanovic S, Benic M, Kirin B K, Vickovic I
Croatian Veterinary Institute Zagreb, Zagreb, Croatia.
Int J Tuberc Lung Dis. 2007 Jun;11(6):652-8.
This paper describes an outbreak of human and related bovine tuberculosis (TB) caused by Mycobacterium caprae in Croatia. A 13-year-old boy clinically presented enlargement of cervical lymph node with consecutive isolation of M. caprae. His 7-year-old sister, who had no clinical signs of disease, hyper-reacted to the purified protein derivative (PPD) test (>25 mm) and peribronchial infiltration was found by radiology. The children came from a family that ran a small-sized cattle dairy farm.
All cattle on the farm were subjected to cutaneous TB testing: six of the 14 reacted positive, while three were suspicious. The entire herd was slaughtered, their carcasses examined and collected material subjected to pertinent diagnostic procedures.
Gross examination findings consistent with TB were observed in the PPD-positive cows. Mycobacteria isolated from the boy and cattle were identified by classical and molecular methods, confirming M. caprae as the causative agent.
Although not bacteriologically proven, consumption of raw milk or non-pasteurised milk products from infected dairy cattle was suspected as the source of infection in humans. Our findings confirm the domination of M. caprae among cattle in Croatia and represent the first evidence of M. caprae infection in humans in Croatia.
本文描述了克罗地亚由山羊分枝杆菌引起的人类及相关牛结核病疫情。一名13岁男孩临床上表现为颈部淋巴结肿大，随后分离出山羊分枝杆菌。他7岁的妹妹没有疾病的临床症状，但对纯化蛋白衍生物（PPD）试验反应过度（>25毫米），放射学检查发现有支气管周围浸润。这些孩子来自一个经营小型奶牛场的家庭。
对农场所有牛进行皮肤结核检测：14头牛中有6头反应呈阳性，3头可疑。整个牛群被屠宰，检查其尸体，并对采集的材料进行相关诊断程序。
在PPD阳性奶牛中观察到与结核病一致的大体检查结果。通过经典和分子方法对从男孩和牛身上分离出的分枝杆菌进行鉴定，确认山羊分枝杆菌为病原体。
虽然未经细菌学证实，但怀疑食用受感染奶牛的生奶或未巴氏杀菌的奶制品是人类感染源。我们的研究结果证实了山羊分枝杆菌在克罗地亚牛群中的主导地位，并代表了克罗地亚人类感染山羊分枝杆菌的首个证据。
