Moliner Prada C, Sánchez Porto A, Asencio Rojas I, Crespo Anguita N, Huertas Cifredo M C, Muñoz Lucena F
Unidad Docente de Medicina Familiar y Comunitaria, Hospital Universitario de Valme, Sevilla.
Enferm Infecc Microbiol Clin. 1991 Feb;9(2):82-4.
Between march '88 and august '89 a total number of 437 contacts (CT) with 69 patients with tuberculosis were analyzed. According to the bacteriological status of the index case the observations were distributed into: Group I (197) CT with patients with positive sputum AFB stain test; Group II (24) CT with cases with positive sputum culture but negative AFB stain; and Group III (216) CT with cases with histologic diagnosis or cases in children. Following identical criteria and according to the bacteriologic situation of the Source case, we grouped the contacts on groups A (246), B (17), and C (174). A clinical history, thorax radiography, and tuberculin test with 2 UT of PPD-RT 23 were performed in all CT cases. Tuberculin reaction was equal or greater than 6 mm in 45% (88/197), 25% (6/24), and 36% (77/216) of groups I, II, and III respectively. This reaction was also positive in 49% (121/246), 23% (4/17), and 26% (46/174) of groups A, B, and C respectively. Sixteen new cases of tuberculosis were discovered among which we identified 5 new source cases. A second tuberculin test was performed in 44% (116/266) of CT with a previous negative test, and in this population we observed 16 conversions. It is demonstrated: 1) a high yield in the detection of infection/tuberculous disease; 2) the analysis of CT in group A provided the highest index of tuberculous infection, and 3) revision of CT of groups II and III provided most of the new cases of disease as well as the identification of 5 new source cases.
1988年3月至1989年8月期间，对与69例结核病患者的总共437次接触（CT）进行了分析。根据索引病例的细菌学状况，观察结果分为：第一组（197例）为与痰涂片抗酸杆菌染色试验阳性患者的接触；第二组（24例）为与痰培养阳性但抗酸杆菌染色阴性病例的接触；第三组（216例）为与组织学诊断病例或儿童病例的接触。按照相同标准并根据传染源病例的细菌学情况，我们将接触者分为A组（246例）、B组（17例）和C组（174例）。对所有接触者病例均进行了临床病史、胸部X线检查以及用2单位PPD-RT 23进行结核菌素试验。结核菌素反应在第一组、第二组和第三组中分别有45%（88/197）、25%（6/24）和36%（77/216）等于或大于6毫米。该反应在A组、B组和C组中分别也有49%（121/246）、23%（4/17）和26%（46/174）呈阳性。发现了16例新的结核病病例，其中我们确定了5例新的传染源病例。对之前结核菌素试验阴性的44%（116/266）的接触者进行了第二次结核菌素试验，在这部分人群中我们观察到16例阳转。结果表明：1）在感染/结核病检测方面有很高的检出率；2）对A组接触者的分析提供了最高的结核感染指标；3）对第二组和第三组接触者的复查发现了大部分新的疾病病例以及确定了5例新的传染源病例。
