{"title":"对传染性肺结核患者密切接触者的监控:一项前瞻性队列研究。","authors":"Zichun Ma, Shujuan Duan, Wei Wang, Rongmei Liu, Shanshan Li, Yuanyuan Shang, Xuxia Zhang, Jinfeng Yuan, Mengqiu Gao, Yu Pang","doi":"10.1186/s13756-024-01419-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A long-term follow-up of close contacts to monitor their infection status is essential to formulate a promising screening strategy. The study aimed to assess the dynamics of tuberculosis (TB) infection using Interferon-γ release assay (IGRA) and determine risk factors associated with TB infection.</p><p><strong>Methods: </strong>Definite TB patients were interviewed and their household contacts were screened for TB infection by IGRA during 12-month longitudinal investigation.</p><p><strong>Results: </strong>We included in our analyses 184 household contacts of 92 index TB patients. 87 individuals (47.3%) in contact group progressed to TB infection, of whom 86 developed into IGRA positive within 24 weeks. Close contacts with a higher age and comorbidities are easier to exhibit TB infection. Analysis showed that risk factors for becoming IGRA-positive individuals included residence, older age, comorbidities, BCG scar and high bacterial load. Contacts with BCG scar had a lower IGRA-positive rate.</p><p><strong>Conclusion: </strong>IGRA conversion generally occurs within 24 weeks after exposure. The TB transmission happens since subclinical TB stage and the presence of BCG scar is an independent protective factor reducing risk of TB infection among close contacts. Repeated IGRA tests are sensible to conducted among close contacts at 24 weeks after exposure to identify the IGRA-positive individuals.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"13 1","pages":"59"},"PeriodicalIF":4.8000,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163748/pdf/","citationCount":"0","resultStr":"{\"title\":\"Surveillance of close contacts of patients with infectious tuberculosis: a prospective cohort study.\",\"authors\":\"Zichun Ma, Shujuan Duan, Wei Wang, Rongmei Liu, Shanshan Li, Yuanyuan Shang, Xuxia Zhang, Jinfeng Yuan, Mengqiu Gao, Yu Pang\",\"doi\":\"10.1186/s13756-024-01419-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A long-term follow-up of close contacts to monitor their infection status is essential to formulate a promising screening strategy. The study aimed to assess the dynamics of tuberculosis (TB) infection using Interferon-γ release assay (IGRA) and determine risk factors associated with TB infection.</p><p><strong>Methods: </strong>Definite TB patients were interviewed and their household contacts were screened for TB infection by IGRA during 12-month longitudinal investigation.</p><p><strong>Results: </strong>We included in our analyses 184 household contacts of 92 index TB patients. 87 individuals (47.3%) in contact group progressed to TB infection, of whom 86 developed into IGRA positive within 24 weeks. Close contacts with a higher age and comorbidities are easier to exhibit TB infection. Analysis showed that risk factors for becoming IGRA-positive individuals included residence, older age, comorbidities, BCG scar and high bacterial load. Contacts with BCG scar had a lower IGRA-positive rate.</p><p><strong>Conclusion: </strong>IGRA conversion generally occurs within 24 weeks after exposure. The TB transmission happens since subclinical TB stage and the presence of BCG scar is an independent protective factor reducing risk of TB infection among close contacts. Repeated IGRA tests are sensible to conducted among close contacts at 24 weeks after exposure to identify the IGRA-positive individuals.</p>\",\"PeriodicalId\":7950,\"journal\":{\"name\":\"Antimicrobial Resistance and Infection Control\",\"volume\":\"13 1\",\"pages\":\"59\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2024-06-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163748/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Antimicrobial Resistance and Infection Control\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13756-024-01419-z\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antimicrobial Resistance and Infection Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13756-024-01419-z","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
摘要
背景:对密切接触者进行长期随访以监测其感染状况对于制定有前景的筛查策略至关重要。本研究旨在使用干扰素-γ释放测定(IGRA)评估结核病(TB)感染的动态,并确定与 TB 感染相关的风险因素:方法:在为期 12 个月的纵向调查中,对确诊肺结核患者进行访谈,并通过 IGRA 对其家庭接触者进行肺结核感染筛查:我们分析了 92 名确诊肺结核患者的 184 名家庭接触者。接触者中有 87 人(47.3%)发展为肺结核感染,其中 86 人在 24 周内发展为 IGRA 阳性。年龄越大、合并症越多的密切接触者越容易感染肺结核。分析表明,成为 IGRA 阳性者的风险因素包括居住地、年龄较大、合并症、卡介苗疤痕和高细菌负荷。有卡介苗疤痕的接触者的 IGRA 阳性率较低:结论:IGRA 转阴一般发生在接触后 24 周内。结论:IGRA 转换一般发生在接触后 24 周内,结核病传播发生在亚临床结核病阶段,卡介苗疤痕的存在是降低密切接触者结核病感染风险的一个独立保护因素。最好在接触后 24 周对密切接触者进行重复 IGRA 检测,以确定 IGRA 阳性者。
Surveillance of close contacts of patients with infectious tuberculosis: a prospective cohort study.
Background: A long-term follow-up of close contacts to monitor their infection status is essential to formulate a promising screening strategy. The study aimed to assess the dynamics of tuberculosis (TB) infection using Interferon-γ release assay (IGRA) and determine risk factors associated with TB infection.
Methods: Definite TB patients were interviewed and their household contacts were screened for TB infection by IGRA during 12-month longitudinal investigation.
Results: We included in our analyses 184 household contacts of 92 index TB patients. 87 individuals (47.3%) in contact group progressed to TB infection, of whom 86 developed into IGRA positive within 24 weeks. Close contacts with a higher age and comorbidities are easier to exhibit TB infection. Analysis showed that risk factors for becoming IGRA-positive individuals included residence, older age, comorbidities, BCG scar and high bacterial load. Contacts with BCG scar had a lower IGRA-positive rate.
Conclusion: IGRA conversion generally occurs within 24 weeks after exposure. The TB transmission happens since subclinical TB stage and the presence of BCG scar is an independent protective factor reducing risk of TB infection among close contacts. Repeated IGRA tests are sensible to conducted among close contacts at 24 weeks after exposure to identify the IGRA-positive individuals.
期刊介绍:
Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.