Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E10, Atlanta, GA 30333, USA.
Emerg Infect Dis. 2011 Mar;17(3):425-31. doi: 10.3201/eid1703.101550.
To understand circumstances of tuberculosis transmission that strain public health resources, we systematically reviewed Centers for Disease Control and Prevention (CDC) staff reports of US outbreaks in which CDC participated during 2002-2008 that involved ≥3 culture-confirmed tuberculosis cases linked by genotype and epidemiology. Twenty-seven outbreaks, representing 398 patients, were reviewed. Twenty-four of the 27 outbreaks involved primarily US-born patients; substance abuse was another predominant feature of outbreaks. Prolonged infectiousness because of provider- and patient-related factors was common. In 17 outbreaks, a drug house was a notable contributing factor. The most frequently documented intervention to control the outbreak was prioritizing contacts according to risk for infection and disease progression to ensure that the highest risk contacts were completely evaluated. US-born persons with reported substance abuse most strongly characterized the tuberculosis outbreaks in this review. Substance abuse remains one of the greatest challenges to controlling tuberculosis transmission in the United States.
为了了解消耗公共卫生资源的结核病传播情况，我们系统性地回顾了疾病预防控制中心（CDC）工作人员在 2002-2008 年参与的美国暴发事件报告，这些暴发涉及通过基因型和流行病学联系起来的≥3 例培养确诊的结核病病例。共审查了 27 起暴发事件，涉及 398 名患者。27 起暴发中有 24 起主要涉及美国出生的患者；滥用药物也是暴发的另一个主要特征。由于提供者和患者相关因素，传染性延长很常见。在 17 起暴发中，毒品屋是一个显著的促成因素。控制暴发最常记录的干预措施是根据感染和疾病进展的风险对接触者进行优先排序，以确保对风险最高的接触者进行全面评估。在本次审查中，有报告滥用药物的美国出生者最能说明结核病暴发的特征。在美国，滥用药物仍然是控制结核病传播的最大挑战之一。
