Emerg Infect Dis. 2019 Mar;25(3):523-528. doi: 10.3201/eid2503.181596.
In this retrospective study, we assessed the safety of window period prophylaxis and proportion of tuberculin skin test (TST) conversions in children <5 years of age who were exposed to an adult with tuberculosis disease during 2007-2017. Children included in this study had unremarkable examination and chest radiograph findings and negative test results for TB infection. In total, 752 children (41% cohabitating with the index patient) received prophylaxis during the window period, usually directly observed therapy with isoniazid. Hepatotoxicity and tuberculosis disease did not develop in any child. TST conversion occurred in 37 (4.9%) children and was associated with the index patient being the child's parent (odds ratio 3.2, 95% CI 1.2-8.2). TST conversion was not associated with sputum smear results, culture positivity, or cohabitation. Thresholds for initiation of window prophylaxis in exposed young children should be low given the safety of medication and difficulties with risk stratification.
在这项回顾性研究中，我们评估了在 2007 年至 2017 年间，5 岁以下儿童接触患有结核病的成年人时，窗口期预防的安全性和结核菌素皮肤试验 (TST) 转化率。本研究纳入的儿童检查和胸部 X 线检查均无异常，且结核感染检测结果均为阴性。共有 752 名儿童（41%与索引患者同住）在窗口期接受了预防治疗，通常是异烟肼直接观察治疗。没有儿童发生肝毒性或结核病。37 名（4.9%）儿童发生 TST 转化，与索引患者是儿童的父母有关（比值比 3.2，95%CI 1.2-8.2）。TST 转化与痰涂片结果、培养阳性或同住无关。鉴于药物的安全性和风险分层的困难，对于接触的幼儿，应降低启动窗口期预防的阈值。
