摘要:

Recurrent tuberculosis is an important indicator of the effectiveness of tuberculosis control and can occur by relapse or exogenous reinfection. We conducted a retrospective cohort study on all bacteriologically confirmed tuberculosis cases that were successfully treated between 2000 and 2012 in Shanghai, an urban area with a high number but a low prevalence rate of tuberculosis cases and a low prevalence of HIV infection. Genotyping the Mycobacterium tuberculosis from clinical isolates was used to distinguish between relapse and reinfection. In total, 5.3% (710/13,417) of successfully treated cases had a recurrence, a rate of 7.55 (95% CI 7.01-8.13) episodes per 1000 person-years, more than 18 times the rate of tuberculosis in the general population. Patients who were male, age 30-59, retreatment cases, had cavitation, diabetes, drug-resistant or multidrug-resistant tuberculosis in their initial episode of tuberculosis, were at high risk for a recurrence. Among 141 recurrent cases that had paired isolates, 59 (41.8%) had different genotypes, indicating reinfection with a different strain. Patients who completed treatment were still at high risk of another episode of tuberculosis and exogenous reinfection contributed a significant proportion of the recurrent tuberculosis cases. Targeted control strategies are needed to prevent new tuberculosis infections in this setting.

附注:

Shen, Xin Yang, Chongguang Wu, Jie Lin, Senlin Gao, Xu Wu, Zheyuan Tian, Jiyun Gan, Mingyu Luo, Tao Wang, Lili Yu, Chenlei Mei, Jian Pan, Qichao DeRiemer, Kathryn Yuan, ZhengAn Gao, Qian eng D43 TW007887/TW/FIC NIH HHS/ D43 TW009343/TW/FIC NIH HHS/ DP2 OD006452/OD/NIH HHS/ R25 TW009343/TW/FIC NIH HHS/ Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Scotland Tuberculosis (Edinb). 2017 Mar;103:97-104. doi: 10.1016/j.tube.2017.01.007. Epub 2017 Jan 31.

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