Infectivity of Mycobacterium tuberculosis Genotypes and Outcome of Contact Investigation in Classroom in Guangxi, China
Infectivity of Mycobacterium tuberculosis Genotypes and Outcome of Contact Investigation in Classroom in Guangxi, China
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中国广西课堂结核杆菌基因型传染性及接触者调查结果
DOI：
10.1155/2019/3980658
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Chongsuvivatwong, Virasakdi
中科院分区：
文献类型：
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作者：
Pan, Dongxiang;Palittapongarnpim, Prasit;Chongsuvivatwong, Virasakdi
目的了解广西青少年学校教室指标病例结核分枝杆菌（mtb）基因型的感染性。方法对广西2016年11月- 2017年12月报告的所有指标结核病例进行青少年学校接触者调查。用15个位点的分枝杆菌穿插重复单元-变数串联重复和spoligo分型方法对指数病例和接触病例进行基因型鉴定。结果变量为结核菌素皮肤试验（TST）结果对新发活动性结核病的5个水平排序[0- 5mm、6- 9mm、10- 14mm、≥15mm（无TB）和≥15mm（有TB）]。采用多变量有序logistic回归分析，评价指示病例基因型对接触者筛查结果的独立影响。结果北京基因型多见于女性指数患者。检测到2例指数病例和2例接触病例的1个基因型聚类。指标病例北京基因型传染性与接触者调查结果的单因素分析有统计学意义，但经接触者特征和性别调整后无统计学意义（P值=0.057）。女性指标病例增加了接触者中结核病感染/活动性结核病的机会（顺序优势比= 1.39,95%置信区间：1.21,1.60）。中学学历、非汉族和无卡介苗疤痕的接触者结核感染/活动性结核的风险增加。结论北京菌株比非北京菌株更易在学校传播结核。
Objective To evaluate the infectivity of Mycobacterium tuberculosis (M.tb) genotypes of index cases in the classroom of adolescent schools in Guangxi, China. Methods Adolescent school tuberculosis (TB) contact investigations were conducted for all reported index TB cases from November 2016 to December 2017 in Guangxi, China. Genotypes of index cases and contact cases were identified by 15-loci mycobacterial interspersed repetitive units–variable number tandem repeat and spoligotyping. Outcome variable was 5 levels' order of tuberculin skin test (TST) results to new active TB [0-5 mm, 6-9 mm, 10-14 mm, ≥ 15 mm (without TB), and ≥15 mm (with TB)]. Multivariate ordered logistic regression analysis was performed to evaluate the independent effect of genotypes of index case on contact screening outcome. Results Beijing genotype occurred more commonly in female index patients. One genotypic cluster of two index cases and one cluster of two contact cases were detected. The association between infectivity of Beijing genotype of index cases and outcome of contact investigation was statistically significant in univariate analysis but no so after adjustment for characteristics of contacts and sex of index cases (P value=0.057). Female index cases increased the chance for TB infection/being active TB among contacts (ordinal odds ratio = 1.39, 95% confidence interval: 1.21, 1.60). Contacts who studied in the middle school, who with non-Han ethnicity and who without BCG scar had increased risk for TB infection/being active TB. Conclusion There was not enough evidence from our data to support that Beijing strains were more infective than non-Beijing strains in TB transmission in school setting.