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[使用QuantiFeron TB-2G检测对外国人结核病感染情况的分析]

[Analysis of tuberculosis infection among foreigners using QuantiFeron TB-2G test].

作者信息

Higuchi Kazue, Harada Nobuyuki, Nagasaka Yuji, Mori Toru

机构信息

Immunology Division, Research Institute of Tuberculosis, JATA, 3-1-24, Matsuyama, Kiyose-shi, Tokyo 204-8533, Japan.

出版信息

Kekkaku. 2007 Jun;82(6):515-21.

Abstract

OBJECTIVE

The purpose of this study was to investigate contacts of a tuberculosis patient among foreigners using QuantiFERON TB-2G (QFT-2G) test.

SUBJECTS AND METHODS

Three index cases in this study were all foreigners. Contacts, who were mostly foreigners and some Japanese, were investigated by a chest X-ray examination, tuberculin skin test (TST) and QFT-2G, and all data were compared.

RESULTS

Among 48 subjects (30 Vietnamese and 18 Japanese) in case 1, 8 Vietnamese and 2 Japanese were QFT-2G positive. One contacts among 3 most close contacts who lived in the same room with the index case was QFT-2G positive. In case 2, three Chinese among 22 contacts were QFT-2G positive, and a very close contact who lived in the next door to the index case was QFT-2G negative. Seven QFT-2G positive Chinese were identified among 24 contacts in case 3. However, four very close contacts among them were QFT-2G negative.

CONCLUSION

Although it was unclear whether QFT-2G positives in cases 1 and 2 were infected with M. tuberculosis through the index cases, it is possible to speculate that these QFT-2G positives were already infected with M. tuberculosis while they live in their own country based on the prevalence of TB in their countries and the fact that many very close contacts were QFT-2G negative. Also, it was suggested that QFT-2G positives in case 3 may not be infected through the index case, but infected in their country, since all close contacts were QFT-2G negative. The results of this study suggested that using the QFT-2G test for foreigners prior to or soon after their entry to Japan and recommending chemoprophylaxis for those who are QFT-2G positive would be a very efficient control measures against immigrant foreigners with TB infection.

摘要

目的

本研究旨在使用结核感染检测试剂盒(QFT-2G)调查一名外国结核病患者的接触者情况。

对象与方法

本研究中的3例索引病例均为外国人。接触者大多为外国人,也有一些日本人,对其进行了胸部X光检查、结核菌素皮肤试验(TST)和QFT-2G检测,并对所有数据进行了比较。

结果

在病例1的48名对象(30名越南人和18名日本人)中,8名越南人和2名日本人的QFT-2G检测呈阳性。与索引病例同住一室的3名最密切接触者中有1名接触者的QFT-2G检测呈阳性。在病例2的22名接触者中,3名中国人的QFT-2G检测呈阳性,而住在索引病例隔壁的一名非常密切的接触者的QFT-2G检测呈阴性。在病例3的24名接触者中,有7名中国人的QFT-2G检测呈阳性。然而,其中4名非常密切的接触者的QFT-2G检测呈阴性。

结论

虽然病例1和病例2中QFT-2G检测呈阳性者是否通过索引病例感染结核分枝杆菌尚不清楚,但根据其本国结核病的流行情况以及许多非常密切的接触者QFT-2G检测呈阴性这一事实,可以推测这些QFT-2G检测呈阳性者在本国生活期间可能已经感染了结核分枝杆菌。此外,病例3中QFT-2G检测呈阳性者可能并非通过索引病例感染,而是在其本国感染,因为所有密切接触者的QFT-2G检测均为阴性。本研究结果表明,在外国人进入日本之前或之后不久对其进行QFT-2G检测,并对QFT-2G检测呈阳性者推荐化学预防,将是针对感染结核病的外国移民的非常有效的控制措施。

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