Fox G J, Anh N T, Nhung N V, Loi N T, Hoa N B, Ngoc Anh L T, Cuong N K, Buu T N, Marks G B, Menzies D
University of Sydney, Camperdown, New South Wales, Australia.
National Lung Hospital, Hanoi, Viet Nam.
Int J Tuberc Lung Dis. 2017 Mar 1;21(3):297-302. doi: 10.5588/ijtld.16.0576.
Differences in the prevalence of latent tuberculous infection (LTBI) and tuberculosis (TB) disease among contacts of patients with multidrug-resistant TB (MDR-TB) and drug-susceptible TB are not well understood.
To compare the prevalence of tuberculin skin test (TST) positivity in household contacts of patients with MDR-TB and in contacts of patients never previously treated for TB ('new TB').
Consecutive patients with MDR-TB and their household contacts at nine urban district clinics in Viet Nam were screened for TB and LTBI, and followed up for 6 months. LTBI was defined as a TST result of at least 10 mm.
A total of 167 patients with TB and their 337 household contacts were recruited. A total of 167/180 (25.8%) contacts of new TB patients and 60/147 (40.8%) contacts of MDR-TB patients were TST-positive (odds ratio [OR] 2.0, 95%CI 1.3-3.2). Contacts of MDR-TB patients were more likely to have baseline chest radiograph findings consistent with TB (OR 2.6, 95%CI 1.4-5.0).
Contacts of MDR-TB patients have a high risk of developing TB. Measures to reduce Mycobacterium tuberculosis transmission and accelerate the detection of disease among high-risk contacts should be prioritised to curb the MDR-TB epidemic.
耐多药结核病（MDR-TB）患者与药物敏感结核病患者的接触者中潜伏结核感染（LTBI）和结核病（TB）疾病的患病率差异尚不清楚。
比较耐多药结核病患者家庭接触者和既往从未接受过结核病治疗的患者（“新发结核病”）接触者中结核菌素皮肤试验（TST）阳性的患病率。
在越南9个市区诊所对耐多药结核病连续患者及其家庭接触者进行结核病和潜伏结核感染筛查，并随访6个月。潜伏结核感染定义为TST结果至少为10毫米。
共招募了167例结核病患者及其337名家庭接触者。新发结核病患者的接触者中共有167/180（25.8%）TST呈阳性，耐多药结核病患者的接触者中有60/147（40.8%）TST呈阳性（比值比[OR]2.0，95%置信区间1.3-3.2）。耐多药结核病患者的接触者更有可能有与结核病相符的基线胸部X线检查结果（OR 2.6，95%置信区间1.4-5.0）。
耐多药结核病患者的接触者发生结核病的风险很高。应优先采取措施减少结核分枝杆菌传播，并加快在高危接触者中发现疾病，以遏制耐多药结核病的流行。
