Institute for Medical Microbiology, National Centre for Mycobacteria, University of Zurich, Zurich, Switzerland.
Euro Surveill. 2014 Mar 20;19(11):20736. doi: 10.2807/1560-7917.es2014.19.11.20736.
The goal of the present study was to examine the transmission dynamics of multidrug-resistant tuberculosis (MDR-TB) in Switzerland. Between 2006 and 2012, a total of 49 MDR-TB cases were reported to the Swiss Federal Office of Public Health, 46 of which were of foreign origin. All 49 initial strains were evaluated by molecular epidemiologic methods at the Swiss National Reference Centre for Mycobacteria. In 43 strains, unique DNA fingerprint patterns were identified. Twelve strains were grouped into six clusters. Data from contact tracing suggest likely in-country transmission in four clusters, mostly among close contacts. In the remaining two clusters, no contact tracing data were available, but the identified genotypes were known to be prevalent in the countries of origin of the patients, suggesting the possibility that the infection was acquired there. While most MDR-TB cases are imported to Switzerland, at least four of the 49 MDR-TB cases were due to transmission within the country. The imported cases, however, did not lead to secondary cases outside the circles of close contacts. The results also indicate that prevention of MDR-TB transmission among immigrants may require closer monitoring.
本研究旨在探讨瑞士耐多药结核病（MDR-TB）的传播动态。2006 年至 2012 年间，瑞士联邦公共卫生办公室共报告了 49 例 MDR-TB 病例，其中 46 例为外国来源。瑞士国家分枝杆菌参考中心采用分子流行病学方法对所有 49 株初始菌株进行了评估。在 43 株中，鉴定出了独特的 DNA 指纹图谱。12 株分为 6 个聚类。接触者追踪数据表明，在 4 个聚类中可能存在国内传播，主要发生在密切接触者之间。在其余两个聚类中，没有接触者追踪数据，但鉴定出的基因型在患者原籍国很常见，表明感染可能发生在那里。虽然大多数 MDR-TB 病例是输入瑞士的，但在 49 例 MDR-TB 病例中，至少有 4 例是由于国内传播引起的。然而，输入病例并没有导致密切接触者圈子之外的继发性病例。结果还表明，预防移民中的 MDR-TB 传播可能需要更密切的监测。
