Understanding Tuberculosis Transmission in the United Kingdom: Findings From 6 Years of Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeats Strain Typing, 2010-2015
Understanding Tuberculosis Transmission in the United Kingdom: Findings From 6 Years of Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeats Strain Typing, 2010-2015
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DOI：
10.1093/aje/kwy119
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发表时间：
2018-10-01
影响因子：
5
通讯作者：
Lalor, Maeve K.
中科院分区：
文献类型：
--
作者：
Davidson, Jennifer A.;Thomas, H. Lucy;Lalor, Maeve K.
基因分型提供了更好地了解结核病（TB）传播的机会。我们利用菌株分型数据来评估集群比例的趋势，并确定与最近英国（UK）传播相关的个体和集群的特征。在这项回顾性队列分析中，我们纳入了2010年至2015年期间来自英国的所有培养证实的菌株型结核病报告，以估计随时间推移聚集的患者比例。我们采用多变量逻辑回归分析探讨了一组患者的特征。总体而言，58.5%的结核病患者集中在2，701个聚集区。2010年（58.7%）至2015年（55.3%），一个集群中的患者比例下降（P = 0.001）。作为一个聚集性患者与男性和英国出生，有肺部疾病，有以前的结核病诊断，并有药物滥用或监禁的历史。我们的研究结果表明，英国的结核病传播在2010年至2015年期间有所下降，在此期间结核病发病率也有所下降。有针对性的集群调查和扩展接触者追踪应针对处于传播链风险中的人员，包括在肺部疾病患者比例较高的集群中具有社会风险因素的英国出生的个人。
Genotyping provides the opportunity to better understand tuberculosis (TB) transmission. We utilized strain typing data to assess trends in the proportion of clustering and identify the characteristics of individuals and clusters associated with recent United Kingdom (UK) transmission. In this retrospective cohort analysis, we included all culture-confirmed strain-typed TB notifications from the UK between 2010 and 2015 to estimate the proportion of patients that clustered over time. We explored the characteristics of patients in a cluster using multivariable logistic regression. Overall, 58.5% of TB patients were concentrated in 2,701 clusters. The proportion of patients in a cluster decreased between 2010 (58.7%) and 2015 (55.3%) (P = 0.001). Being a clustered patient was associated with being male and UK-born, having pulmonary disease, having a previous TB diagnosis, and having a history of drug misuse or imprisonment. Our results suggest that TB transmission in the UK decreased between 2010 and 2015, during which time TB incidence also decreased. Targeted cluster investigation and extended contact tracing should be aimed at persons at risk of being in a transmission chain, including UK-born individuals with social risk factors in clusters with a high proportion of patients having pulmonary disease.