论文部分内容阅读
背景:儿童如果发生结核病,通常会假设其传染源是生活在同一家庭的成年传染性病例。本研究应用限定性片断长度多态性分析技术(RFLP)来确定从传染源到儿童的传播。设计:收集1993年到1998年诊断的成人及儿童结核病例和他们的结核分枝杆菌培养物。通过访视和结核分枝杆菌菌株的RFLP分析来确定流行病学联系及证实家庭内传播。结果:1291名成人中有1139名(91％)和417名儿童中有65名(16％)籍培养结果证实为结核病。由于要重新收集痰标本和提取DNA的问题,仅对其中的832名成人和35名儿童进行了RFLP分析:19名(54％)儿童有家庭成员确诊为结核病,12名儿童 有与其家庭成员相同的菌株。分离自儿童的29株(83％)菌株构成了社区簇的一部分,但与传染源有明确接触史者只有15株。结论:在具有传染性成人肺结核病例的家庭中,儿童患有结核病并不意味着必然是成人对儿童的传播。儿童可能是在社区也可能是在家庭中受到感染。此结果对在高发病率地区的接触者追踪及治疗策略有意义。
Background: Children with tuberculosis usually assume that the source of infection is an adult infectious case of the same family. In this study, a restriction fragment length polymorphism (RFLP) was used to determine the transmission from the source of infection to children. Design: Collection of tuberculosis cases in adults and children diagnosed between 1993 and 1998 and their cultures of M. tuberculosis. Epidemiological linkages and confirmation of transmission within the family were confirmed by visit and RFLP analysis of M. tuberculosis strains. RESULTS: A total of 1139 out of 1291 adults (91%) and 65 (16%) of 417 children were confirmed as tuberculosis. RFLP analysis was performed on only 832 adults and 35 children because of the need to re-collect sputum samples and DNA extraction: 19 (54%) of the children had family members diagnosed with tuberculosis and 12 had the same family members Of the strain. Twenty-nine strains (83%) isolated from children form part of the community cluster, but only 15 have a clear history of exposure to the source of infection. Conclusion: Children with tuberculosis do not necessarily mean adult transmission of children in families with infectious tuberculosis cases. Children may be infected in the community or at home. This result is meaningful for contact tracing and treatment strategies in high incidence areas.