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结核患者家庭内和家庭外接触者间的传播程度。

Magnitude of transmission among household and non-household contacts of TB patients.

机构信息

Curry International Tuberculosis Center, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA.

Curry International Tuberculosis Center, Division of Pulmonary and Critical Care Medicine, University of California San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA, Division of Pulmonary Medicine, Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, South Korea.

出版信息

Int J Tuberc Lung Dis. 2019 Apr 1;23(4):433-440. doi: 10.5588/ijtld.18.0273.

DOI:10.5588/ijtld.18.0273
PMID:31064622
Abstract

SETTING The household and non-household contacts of patients with tuberculosis (TB) face varying degrees of risk of infection by . OBJECTIVE To quantify new infection and to determine the risk factors associated with new infection among named contacts in San Francisco, CA, USA. DESIGN We performed a cohort study in patients with culture-positive pulmonary TB. We analyzed patient, contact, environmental and bacterial characteristics. RESULTS Of the 2422 contacts named by 256 patients, 149 (6.2%) had new infection due to recent transmission from 79 (30.9%) patients. Of the 149 new infections, 87 (58.4%) occurred among household contacts and 62 (41.6%) among non-household contacts. Numerous acid-fast bacilli in sputum (odds ratio [OR] 2.64, 95%CI 1.32-5.25) and contacts being named by more than one patient (OR 2.90, 95%CI 1.23-6.85) were associated with new infection among household contacts. Being older than 50 years (OR 1.93, 95%CI 1.09-3.41) and an Asian/Pacific Islander (OR 3.09, 95%CI 1.50-6.37) were associated with new infection among non-household contacts. CONCLUSIONS Fewer than one third of patients caused new infection to his/her contacts. A substantial proportion of transmission resulting in new infection occurred outside of the household. The risk factors for infection among household and non-household contacts are different and should be considered when prioritizing control interventions. .

摘要

背景 肺结核（TB）患者的家庭和非家庭接触者面临着不同程度的感染风险。 目的 在美国加利福尼亚州旧金山，量化新感染病例，并确定与新感染相关的危险因素。 设计 我们对培养阳性肺结核患者进行了队列研究。我们分析了患者、接触者、环境和细菌特征。 结果 在 256 名患者所报告的 2422 名接触者中，有 149 名（6.2%）因最近从 79 名（30.9%）患者传播而发生新感染。在 149 例新感染中，87 例（58.4%）发生在家庭接触者中，62 例（41.6%）发生在非家庭接触者中。痰中大量抗酸杆菌（比值比[OR]2.64，95%CI1.32-5.25）和一个以上患者提名的接触者（OR2.90，95%CI1.23-6.85）与家庭接触者的新感染相关。年龄大于 50 岁（OR1.93，95%CI1.09-3.41）和亚洲/太平洋岛民（OR3.09，95%CI1.50-6.37）与非家庭接触者的新感染相关。 结论 不到三分之一的患者使他/她的接触者感染了新的感染。导致新感染的传播有相当一部分发生在家庭之外。家庭和非家庭接触者感染的危险因素不同，在优先考虑控制干预措施时应加以考虑。 .

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