Department of Medical Microbiology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Int J Tuberc Lung Dis. 2010 Feb;14(2):223-30.
King George V (KGV) Hospital has the largest tuberculosis (TB) facility in KwaZulu-Natal (KZN), the province with the highest prevalence of TB-HIV (human immunodeficiency virus) co-infection in South Africa. During the study, KGV was the only provincial referral hospital for patients with drug-resistant TB.
To determine the role of nosocomial transmission in patients infected with a new strain of Mycobacterium tuberculosis during treatment.
Insertion sequence 6110-DNA fingerprinting was performed on stored isolates from patients with culture-positive pulmonary TB for more than 6 weeks after treatment started and those who relapsed.
DNA fingerprints of 14 of 26 patients with differing isolates matched those of other patients. Four of them acquired a F15/LAM4/KZN genotype, while two acquired fully susceptible Beijing strains. Three of the four F15/LAM4/KZN strains were multidrug-resistant with identical fingerprint patterns, while the fourth was fully susceptible. One of these was acquired during hospitalisation and three after discharge. Both HIV-infected and non-infected patients are at risk of infection with the F15/LAM4/KZN strain in health care facilities and within the community. Rapid diagnostic tests, separation of TB and non-TB patients on admission and isolation of multidrug-resistant and extensively drug-resistant TB patients are essential to curb nosocomial transmission.
乔治五世国王医院（KGV）是夸祖鲁-纳塔尔省（KZN）最大的肺结核（TB）治疗中心，该省是南非结核病-人类免疫缺陷病毒（HIV）合并感染率最高的地区。在研究期间，KGV 是唯一一家为耐多药结核（MDR-TB）患者提供服务的省级转诊医院。
确定在治疗过程中感染新型结核分枝杆菌的患者中，医院内传播的作用。
对治疗开始后培养阳性的肺结核患者和复发患者的储存分离物进行插入序列 6110-DNA 指纹图谱分析。
26 名不同分离株患者中的 14 名患者的 DNA 指纹图谱与其他患者的匹配。其中 4 名患者获得了 F15/LAM4/KZN 基因型，而 2 名患者获得了完全敏感的北京株。这 4 株 F15/LAM4/KZN 株中有 3 株为多药耐药，且具有相同的指纹模式，而第 4 株为完全敏感。其中 1 株是在住院期间获得的，3 株是在出院后获得的。HIV 感染者和非感染者都有在医疗机构和社区中感染 F15/LAM4/KZN 株的风险。快速诊断测试、入院时将结核患者和非结核患者分开、以及对耐多药和广泛耐药结核患者进行隔离，对于遏制医院内传播至关重要。
