Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York.
Clin Infect Dis. 2014 Feb;58(3):381-91. doi: 10.1093/cid/cit643. Epub 2013 Sep 24.
Contact investigations among individuals living with drug-susceptible tuberculosis patients (source cases) have shown a high yield of tuberculosis disease and latent tuberculosis, but the yield of such investigations in households of drug-resistant tuberculosis source cases is unknown. In this systematic review and meta-analysis, we found 25 studies that evaluated a median of 111 (interquartile range, 21-302) household contacts of drug-resistant tuberculosis source cases. The pooled yield was 7.8% (95% CI, 5.6%-10.0%) for active tuberculosis and 47.2% (95% CI, 30.0%-61.4%) for latent tuberculosis, although there was significant statistical heterogeneity (P < .0001). More than 50% of secondary cases with drug susceptibility test results were concordant with those of the source case. Among studies that followed household members, the majority of secondary cases were detected within 1 year of the source case's diagnosis. Household contact investigation around drug-resistant tuberculosis patients is a high-yield intervention for detection of drug-resistant tuberculosis and prevention of ongoing transmission.
对与耐多药结核病患者（源病例）同住的个体进行接触者调查显示，结核病和潜伏性结核病的检出率很高，但耐多药源病例家庭中的此类调查的检出率尚不清楚。在这项系统评价和荟萃分析中，我们发现了 25 项评估耐多药结核病源病例中位数为 111 名（四分位距，21-302）家庭接触者的研究。活动性结核病的合并检出率为 7.8%（95%CI，5.6%-10.0%），潜伏性结核病的检出率为 47.2%（95%CI，30.0%-61.4%），尽管存在显著的统计学异质性（P<0.0001）。超过 50%的药物敏感性检测结果与源病例相符的继发病例。在对家庭接触者进行随访的研究中，大多数继发病例是在源病例诊断后 1 年内被发现的。对耐多药结核病患者的家庭接触者进行调查是一种高产出的干预措施，可用于检测耐多药结核病并防止持续传播。
