Kozińska Monika, Bogucka Krystyna, Kędziora Krzysztof, Szpak-Szpakowska Jolanta, Pędzierska-Olizarowicz Wiesława, Pustkowski Andrzej, Augustynowicz-Kopeć Ewa
Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland.
Medical Laboratory BRUSS, ALAB Group, Department of Mycobacterium Tuberculosis Diagnostics, Powstania Styczniowego 9B, 81-519 Gdynia, Poland.
Diagnostics (Basel). 2022 Feb 8;12(2):438. doi: 10.3390/diagnostics12020438.
Drug-resistant TB (DR-TB) in children is a special epidemiological, clinical, and diagnostic problem, and its global incidence remains unknown. DR-TB in children is usually of a primary nature and is most often transmitted to the child from a household contact, so these cases reflect the prevalence of DR-TB in the population of adult patients. The risk of infection with complex (MTBC) in children depends on age, duration of exposure, proximity of contact with the infected person, and the level of source virulence. Most cases of TB in children, especially in infants, are caused by household contacts, where the main sources of infection are parents, grandparents or older siblings. However, there are many documented cases of TB transmission outside the family. The most common source of infection is an adult who is profusely positive for mycobacteria, diagnosed too late, and inadequately treated. It has been estimated that a sputum-positive patient might infect 30-50% of their household members. For this reason, active epidemiological investigation and contact tracing in the environment of sputum-positive patients are the most appropriate methods of identifying infected family members. This paper presents a case report concerning the transmission of extensively drug-resistant TB, Beijing 265 genotype, from a mother to her 10-month-old daughter. It is the first case diagnosed in Poland, and one of very few described in the literature where treatment was effective in the mother and the infant recovered spontaneously.
儿童耐药结核病（DR-TB）是一个特殊的流行病学、临床和诊断问题，其全球发病率尚不清楚。儿童耐药结核病通常为原发性，最常见的是从家庭接触者传播给儿童，因此这些病例反映了成年患者群体中耐药结核病的流行情况。儿童感染复合群结核分枝杆菌（MTBC）的风险取决于年龄、接触时间、与感染者接触的密切程度以及传染源的毒力水平。儿童结核病的大多数病例，尤其是婴儿，是由家庭接触者引起的，主要传染源是父母、祖父母或年长的兄弟姐妹。然而，有许多有记录的家庭外结核病传播病例。最常见的传染源是一名分枝杆菌涂片大量阳性、诊断过晚且治疗不充分的成年人。据估计，一名痰涂片阳性患者可能会感染其30%-50%的家庭成员。因此，在痰涂片阳性患者的环境中开展积极的流行病学调查和接触者追踪是识别受感染家庭成员的最合适方法。本文介绍了一例广泛耐药结核病北京265基因型从母亲传播给其10个月大女儿的病例报告。这是波兰诊断出的首例病例，也是文献中描述的极少数治疗对母亲有效且婴儿自发康复的病例之一。
