Lee Ji-Yeon, Pyo Seong Wook, Kim Jieun, Park Young-Joon
Division of Tuberculosis Policy, Department of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea.
Division of Bacterial Diseases, Department of Laboratory Diagnosis and analysis, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea.
Osong Public Health Res Perspect. 2025 Jun;16(3):292-299. doi: 10.24171/j.phrp.2024.0343. Epub 2025 Apr 16.
In the Republic of Korea, the previous surveillance system for zoonotic tuberculosis (TB) involved the X-ray testing of humans in contact with Mycobacterium bovis-infected livestock. In contrast, the updated surveillance system incorporates the genotyping of cultured Mycobacterium isolates for high-risk occupational groups. This study aimed to systematically document the detection, diagnosis, assessment, and response in the epidemic investigation of zoonotic TB in a laboratory worker in the Republic of Korea.
M. bovis was confirmed using spoligotyping and whole genome sequencing. Clinical characteristics were reviewed through epidemiological investigation and interviews with the affected individual. Transmission routes and secondary spread were assessed via field epidemiological investigations and contact evaluations using chest X-ray and interferon gamma release assay for latent TB infection.
A 56-year-old laboratory worker presented with chest X-ray findings compatible with TB and subsequently tested positive for M. bovis. She had no clinical or family history of TB and remained asymptomatic. She completed a 6 month treatment regimen of isoniazid, rifampin, ethambutol, and pyrazinamide without hospitalization. Although no direct transmission pathways for zoonotic TB were identified, her work in a laboratory, processing specimens for zoonotic TB, indicated potential laboratory related exposure.
This case underscores the importance of stringent use of personal protective equipment among high-risk occupational groups and the implementation of an enhanced surveillance system to report zoonotic TB. These findings highlight the need for a One Health approach and proactive surveillance, emphasizing the necessity of refining and strengthening surveillance systems for precise monitoring and an effective response.
在大韩民国，以前的人畜共患结核病监测系统涉及对接触牛分枝杆菌感染牲畜的人员进行X射线检测。相比之下，更新后的监测系统纳入了对高风险职业群体培养的分枝杆菌分离株进行基因分型。本研究旨在系统记录大韩民国一名实验室工作人员人畜共患结核病疫情调查中的检测、诊断、评估和应对情况。
使用间隔寡核苷酸分型法（spoligotyping）和全基因组测序确认牛分枝杆菌。通过流行病学调查和对受影响个体的访谈回顾临床特征。通过现场流行病学调查以及使用胸部X射线和干扰素γ释放试验评估潜伏性结核感染来评估传播途径和二次传播情况。
一名56岁的实验室工作人员胸部X射线检查结果与结核病相符，随后牛分枝杆菌检测呈阳性。她没有结核病的临床或家族病史，且无症状。她完成了为期6个月的异烟肼、利福平、乙胺丁醇和吡嗪酰胺治疗方案，未住院治疗。虽然未确定人畜共患结核病的直接传播途径，但她在实验室处理人畜共患结核病标本的工作表明存在潜在的实验室相关暴露。
该病例强调了在高风险职业群体中严格使用个人防护设备以及实施强化监测系统以报告人畜共患结核病的重要性。这些发现凸显了采取“同一健康”方法和主动监测的必要性，强调了完善和加强监测系统以进行精确监测和有效应对的必要性。
