Jackson A D, Seagar A-L, Reid M E, Doig C, Forbes K J, Laurenson I F, McMenamin J
Health Protection Scotland, Glasgow, Scotland.
Int J Tuberc Lung Dis. 2009 Apr;13(4):486-93.
Contact investigation resulting from specimens sent to the Scottish Mycobacteria Reference Laboratory.
To characterise patients and types of exposures associated with transmission of a prevalent Mycobacterium tuberculosis genotype in Scotland.
A combined approach using molecular epidemiology and semi-structured patient interviews for social network enquiry.
We investigated social connections between 64 patients diagnosed between 1994 and 2004. Fifty-five per cent had > or = 1 identifiable contact. One third (n = 14, 32.6%) of the 43 epidemiological links detected were discerned as a result of patient interviews and were not previously recorded on surveillance reports, nor recognised by nurse specialists (all were non-household contacts). Sixteen putative sites of exposure were identified, 11 were public houses. Rather than a single-source outbreak, eight pockets of transmission were identified, the largest involving UK-born alcohol-misusing males frequenting several public houses.
Using a standardised approach to explore themes around which individuals may have been exposed to TB resulted in the detection of previously unrecognised epidemiological links. Epidemiological data obtained from cluster investigations, e.g., risk and social behaviours that increase the risk of infection and sites of putative exposure, can enhance the development of more appropriate questions for the contact tracing interview.
因样本送交苏格兰分枝杆菌参考实验室而开展的接触者调查。
对与苏格兰一种常见结核分枝杆菌基因型传播相关的患者及接触类型进行特征描述。
采用分子流行病学与半结构化患者访谈相结合的方法进行社交网络调查。
我们调查了1994年至2004年间确诊的64例患者之间的社会联系。55%的患者有≥1个可识别的接触者。在检测到的43条流行病学关联中，三分之一（n = 14，32.6%）是通过患者访谈发现的，之前未记录在监测报告中，也未被护士专家识别（均为非家庭接触者）。确定了16个可能的暴露地点，其中11个是酒馆。未发现单一来源的暴发，而是识别出8个传播聚集区，最大的聚集区涉及在英国出生、酗酒的男性，他们常去几家酒馆。
采用标准化方法探究个体可能接触结核病的相关主题，从而发现了之前未被识别的流行病学关联。从聚集性调查中获得的流行病学数据，如增加感染风险的风险因素和社会行为以及可能的暴露地点，可有助于为接触者追踪访谈提出更恰当的问题。
