Duration of Exposure Among Close Contacts of Patients With Infectious Tuberculosis and Risk of Latent Tuberculosis Infection.
Duration of Exposure Among Close Contacts of Patients With Infectious Tuberculosis and Risk of Latent Tuberculosis Infection.
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DOI：
10.1093/cid/ciz1044
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发表时间：
2020-10-23
期刊：
影响因子：
--
通讯作者：
Tuberculosis Epidemiologic Studies Consortium Task Order 2 Team
中科院分区：
文献类型：
--
作者：
Reichler MR;Khan A;Yuan Y;Chen B;McAuley J;Mangura B;Sterling TR;Tuberculosis Epidemiologic Studies Consortium Task Order 2 Team
传染性结核病 (TB) 密切接触者中潜伏性结核感染 (LTBI) 的预测因素尚不完全清楚，特别是暴露时间的多少。我们前瞻性地招募了美国和加拿大 9 个卫生部门经培养确诊的肺结核成年患者及其密切接触者。在接触者调查期间，对结核病患者进行了访谈，对密切接触者进行了访谈并筛查了结核病和潜伏性结核病。 3040 名接触者中有 1390 名（46%）被诊断出 LTBI，其中包括 2027 名美国/加拿大出生的接触者中的 624 名（31%）和 1013 名非美国/加拿大出生的接触者中的 766 名（76%）。在多变量分析中，年龄 ≥ 5 岁、男性、非美国/加拿大出生、涂片阳性指标患者、与指标患者共用卧室（各 P < .001），以及接触 > 1 名指标患者 (P < .05)，与 LTBI 诊断相关。 LTBI 患病率随着暴露时间的增加而增加，每 250 小时暴露时间患病率增量增加 8.2% (P < .0001)。对于暴露时间<250 小时的接触者，每 50 暴露小时的患病率没有观察到差异 (P = .63)。接触传染性结核病患者的时间是一个重要的 LTBI 预测因素，可能的风险阈值为 250 小时。更多的暴露、更近的暴露距离和更广泛的患者疾病指数是额外的 LTBI 预测因素。
Predictors of latent tuberculosis infection (LTBI) among close contacts of persons with infectious tuberculosis (TB) are incompletely understood, particularly the number of exposure hours. We prospectively enrolled adult patients with culture-confirmed pulmonary TB and their close contacts at 9 health departments in the United States and Canada. Patients with TB were interviewed and close contacts were interviewed and screened for TB and LTBI during contact investigations. LTBI was diagnosed in 1390 (46%) of 3040 contacts, including 624 (31%) of 2027 US/Canadian-born and 766 (76%) of 1013 non-US/Canadian-born contacts. In multivariable analysis, age ≥5 years, male sex, non-US/Canadian birth, smear-positive index patient, and shared bedroom with an index patient (P < .001 for each), as well as exposure to >1 index patient (P < .05), were associated with LTBI diagnosis. LTBI prevalence increased with increasing exposure duration, with an incremental prevalence increase of 8.2% per 250 exposure hours (P < .0001). For contacts with <250 exposure hours, no difference in prevalence was observed per 50 exposure hours (P = .63). Hours of exposure to a patient with infectious TB is an important LTBI predictor, with a possible risk threshold of 250 hours. More exposures, closer exposure proximity, and more extensive index patient disease were additional LTBI predictors.
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DOI：
10.1093/infdis/jiy265
发表时间：
2018-08-14
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Reichler MR;Khan A;Sterling TR;Zhao H;Moran J;McAuley J;Bessler P;Mangura B;Tuberculosis Epidemiologic Studies Consortium Task Order 2 Team
通讯作者：
Tuberculosis Epidemiologic Studies Consortium Task Order 2 Team
影响因子：
168.9
作者：
Verver, S;Warren, RM;van Helden, PD
通讯作者：
van Helden, PD
影响因子：
11.8
作者：
Reichler, Mary R.;Khan, Awal;Mangura, Bonita
通讯作者：
Mangura, Bonita
影响因子：
158.5
作者：
Horsburgh, C. Robert, Jr.;Rubin, Eric J.
通讯作者：
Rubin, Eric J.
影响因子：
120.7
作者：
Reichler, MR;Reves, R;Onorato, IM
通讯作者：
Onorato, IM