社区结核病发病率下降背景下移植后结核病风险的变化:2008-2020 年全国人口研究。

IF 4.6 2区 医学 Q1 MICROBIOLOGY
JongHoon Hyun, Myeongjee Lee, Inkyung Jung, Eunhwa Kim, Seung Min Hahn, Yu Ri Kim, Sungmin Lim, Kyong Ihn, Min Young Kim, Jong Gyun Ahn, Joon-Sup Yeom, Su Jin Jeong, Ji-Man Kang
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引用次数: 0

摘要

背景:移植受者免疫力低下,很容易患上结核病。然而,在韩国,活动性肺结核的发病率正在迅速下降,但移植受者感染肺结核的趋势尚未得到阐明。本研究旨在评估移植后患活动性肺结核的风险,包括肺结核的风险因素和标准化发病率比,并与普通人群进行比较:这项回顾性研究以韩国健康保险审查和评估数据库为基础,对 2008 年至 2020 年间接受移植手术的人(62484 名受者)进行了调查。比较了疾病负担较重时期(2010-2012 年)和疾病负担较轻时期(2016-2018 年)接受治疗的受者的结核病发病率。使用韩国结核病监测系统分析了标准化发病率比。主要结果是移植后新增结核病例数:结果:在分析的57103名受者中,移植后1年的总体累积发病率为0.8%(95%置信区间[CI]:0.7-0.8),高负担期显著高于低负担期(移植后3年为1.7% vs. 1.0%,P 结论:移植受者很容易罹患结核病:移植受者很容易患上结核病,这可能受到他们的免疫功能低下状况、实体器官移植类型、年龄和社区结核病流行率的影响。应考虑不同国家、移植类型和年龄的结核病流行情况,以便为高危人群制定适当的结核病预防策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Changes in tuberculosis risk after transplantation in the setting of decreased community tuberculosis incidence: a national population-based study, 2008-2020.

Background: Transplant recipients are immunocompromised and vulnerable to developing tuberculosis. However, active tuberculosis incidence is rapidly declining in South Korea, but the trend of tuberculosis infection among transplant recipients has not been elucidated. This study aimed to evaluate the risk of active tuberculosis after transplantation, including risk factors for tuberculosis and standardized incidence ratios, compared with that in the general population.

Methods: This retrospective study was conducted based on the South Korean health insurance review and assessment database among those who underwent transplantation (62,484 recipients) between 2008 and 2020. Tuberculosis incidence was compared in recipients treated during higher- (2010-2012) and lower-disease burden (2016-2018) periods. Standardized incidence ratios were analyzed using the Korean Tuberculosis Surveillance System. The primary outcome was the number of new tuberculosis cases after transplantation.

Results: Of 57,103 recipients analyzed, the overall cumulative incidence rate 1 year after transplantation was 0.8% (95% confidence interval [CI]: 0.7-0.8), significantly higher in the higher-burden period than in the lower-burden period (1.7% vs. 1.0% 3 years after transplantation, P < 0.001). Individuals who underwent allogeneic hematopoietic stem cell transplantation had the highest tuberculosis incidence, followed by those who underwent solid organ transplantation and autologous hematopoietic stem cell transplantation (P < 0.001). The overall standardized incidence ratio was 3.9 (95% CI 3.7-4.2) and was the highest in children aged 0-19 years, at 9.0 (95% CI 5.7-13.5). Male sex, older age, tuberculosis history, liver transplantation, and allogeneic hematopoietic stem cell transplantation were risk factors for tuberculosis.

Conclusions: Transplant recipients are vulnerable to developing tuberculosis, possibly influenced by their immunocompromised status, solid organ transplant type, age, and community prevalence of tuberculosis. Tuberculosis prevalence by country, transplant type, and age should be considered to establish an appropriate tuberculosis prevention strategy for high-risk groups.

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来源期刊
CiteScore
8.60
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Annals of Clinical Microbiology and Antimicrobials considers good quality, novel and international research of more than regional relevance. Research must include epidemiological and/or clinical information about isolates, and the journal covers the clinical microbiology of bacteria, viruses and fungi, as well as antimicrobial treatment of infectious diseases. Annals of Clinical Microbiology and Antimicrobials is an open access, peer-reviewed journal focusing on information concerning clinical microbiology, infectious diseases and antimicrobials. The management of infectious disease is dependent on correct diagnosis and appropriate antimicrobial treatment, and with this in mind, the journal aims to improve the communication between laboratory and clinical science in the field of clinical microbiology and antimicrobial treatment. Furthermore, the journal has no restrictions on space or access; this ensures that the journal can reach the widest possible audience.
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