Shigeto E, Sato H, Shigeto N, Kamada T, Abe C, Takahashi M, Mori T
National Hiroshima Hospital, Japan.
Kekkaku. 1995 May;70(5):347-54.
A twenty-four year old male Peruvian of Japanese origin, who came to Japan in September 1990 and had been working in a minor factory in a rural area, was admitted to a hospital in March '91 with severe cough. Smear examination of his sputum smear was positive for acid-fast bacilli and his chest X-ray showed multiple cavities (Index case). Subsequent contact examination identified further four patients with pulmonary tuberculosis among his colleagues in the factory, all of whom lived in the same house with the index case. During following three years, further six patients with mycobacteriosis, two Peruvians and four Japanese, were found among the employee of that factory. M. tuberculosis was cultured from the sputa obtained from seven of these eleven patients. Another patient was diagnosed as non-tuberculous mycobacteriosis. Restriction fragment length polymorphism (RFLP) analysis carried out with five strains of M. tuberculosis isolated from these patients revealed the identical RFLP pattern which is uncommon in Japan. Still more, an isolate from another patient was subjected to RFLP analysis by chance, and was found to show the same RFLP pattern. Later epidemiological study revealed that the last patient, a 53 year-old saleswoman of boxlunch, might have some contact with the index case at her booth. Though RFLP analysis was not done for the isolate from the index case, from the identity of RFLP patterns of other isolates, clinical course and epidemiological study, it is considered that six patients were certainly, and two others were probably infected from the index case.(ABSTRACT TRUNCATED AT 250 WORDS)
一名24岁的秘鲁籍日裔男性,1990年9月来到日本,一直在农村地区的一家小工厂工作,1991年3月因严重咳嗽入院。其痰液涂片抗酸杆菌检查呈阳性,胸部X光显示有多个空洞(索引病例)。随后的接触者检查在其工厂同事中又发现了另外4例肺结核患者,他们都与索引病例住在同一所房子里。在接下来的三年里,在该工厂的员工中又发现了另外6例分枝杆菌病患者,其中2名秘鲁人和4名日本人。从这11名患者中的7人的痰液中培养出了结核分枝杆菌。另一名患者被诊断为非结核分枝杆菌病。对从这些患者中分离出的5株结核分枝杆菌进行的限制性片段长度多态性(RFLP)分析显示出相同的RFLP模式,这在日本并不常见。此外,偶然对另一名患者的分离株进行RFLP分析,发现其显示出相同的RFLP模式。后来的流行病学研究表明,最后一名患者是一名53岁的盒饭女销售员,可能在她的展位上与索引病例有过接触。虽然没有对索引病例的分离株进行RFLP分析,但从其他分离株的RFLP模式的一致性、临床过程和流行病学研究来看,认为6名患者肯定,另外2名患者可能是从索引病例感染的。(摘要截短为250字)