结核分枝杆菌在旧金山湾区的传播。

Dissemination of Mycobacterium tuberculosis across the San Francisco Bay Area.

作者信息

Bradford W Z, Koehler J, El-Hajj H, Hopewell P C, Reingold A L, Agasino C B, Cave M D, Rane S, Yang Z, Crane C M, Small P M

机构信息

Medical Service, San Francisco General Hospital, and University of California 94110, USA.

出版信息

J Infect Dis. 1998 Apr;177(4):1104-7. doi: 10.1086/517405.

DOI:10.1086/517405

PMID:9534993

Abstract

The propensity of Mycobacterium tuberculosis genotypes to spread across geographic boundaries was investigated by comparing the IS6110 and polymorphic GC-rich sequence patterns of M. tuberculosis isolates from San Francisco and the East Bay, two distinct regions separated by San Francisco Bay. Of 724 isolates from incident tuberculosis patients during 1992 and 1993, only 53 (7.3%) had patterns matching > or = 1 isolates from the other region. In the multivariable analysis of patient risk factors, an AIDS diagnosis (odds ratio [OR], 1.89; 95% confidence interval [CI], 1.00-3.57) and non-Asian race (OR, 3.43; 95% CI, 1.59-7.42) were associated with having an isolate with a matching pattern. Of 375 unique IS6110 patterns among San Francisco isolates, only 9 (2.4%) matched patterns of East Bay isolates. These population-based data suggest that in the San Francisco Bay Area, M. tuberculosis does not rapidly spread across geographic boundaries, and tuberculosis control efforts should focus on transmission within defined areas.

摘要

通过比较来自旧金山和东湾（被旧金山湾隔开的两个不同区域）的结核分枝杆菌分离株的IS6110和富含GC的多态性序列模式，研究了结核分枝杆菌基因型跨越地理边界传播的倾向。在1992年和1993年期间从新发结核病患者中分离出的724株菌株中，只有53株（7.3%）的模式与来自另一区域的≥1株菌株相匹配。在对患者危险因素的多变量分析中，艾滋病诊断（比值比[OR]，1.89；95%置信区间[CI]，1.00 - 3.57）和非亚裔种族（OR，3.43；95%CI，1.59 - 7.42）与分离出具有匹配模式的菌株相关。在旧金山分离株中的375种独特的IS6110模式中，只有9种（2.4%）与东湾分离株的模式相匹配。这些基于人群的数据表明，在旧金山湾区，结核分枝杆菌不会迅速跨越地理边界传播，结核病控制工作应集中在特定区域内的传播上。