Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience

BMC Infectious Diseases

Research Article

Po-Yu Liu¹  Don-Han Wu²  Chieh-Liang Wu³  Wen-Cheng Chao⁴  Chi-Chang Shieh⁵  Pei-Chun Chuang⁶  Ruwen Jou⁷ 

[1] Center for Quality Management, Taichung Veterans General Hospital, Taichung, Taiwan;Department of Internal Medicine, Taichung Veterans General Hospital Chiayi branch, Chiayi, Taiwan;Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;Center for Quality Management, Taichung Veterans General Hospital, Taichung, Taiwan;Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan;Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan;Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan;Reference Laboratory of Mycobacteriology, Tuberculosis Research Center, Centers for Disease Control, No.6, Linsen S. Rd., Jhongjheng District, 10050, Taipei City, Taiwan;Reference Laboratory of Mycobacteriology, Tuberculosis Research Center, Centers for Disease Control, No.6, Linsen S. Rd., Jhongjheng District, 10050, Taipei City, Taiwan;Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan;

关键词: Tuberculosis;    Genotyping;    Transmission;    Long-term care facility;    Outbreak;   

DOI  :  10.1186/s12879-017-2526-2

 received in 2016-09-15, accepted in 2017-06-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundResidents in long-term care facilities (LTCFs) are vulnerable to tuberculosis (TB) transmission; however, to delineate possible routes of TB transmission in LTCFs is difficult. This study aimed to address the use of regular genotyping surveillance to delineate TB transmission in LTCFs.MethodsAll of Mycobacterium tuberculosis isolates in the reported 620-bed LTCF between July 2011 and August 2015 were genotyped, and we retrospectively compared epidemiological data and genotyping results.ResultsA total of 42 subjects were diagnosed with culture-positive pulmonary TB infection during the 4-year period. Their median age was 76.5 years, and 64.3% (27/42) of them were male. Genotyping identified 5 clustered TB infections involving 76.2% (32/42) of all TB subjects. In a multivariate logistic regression model adjusted for age, sex, chronic obstructive pulmonary disease, and body mass index, subjects with clustered TB infection were less likely to be Activities of Daily Living (ADL)-dependence (adjOR 0.073, 95% CI 0.007–0.758) when compared with subjects having individual TB infections. Prolonged surveillance is essential given that the median interval to diagnose secondary subjects was 673 days. Finally, only 63.0% (17/27) of the 27 secondary TB subjects in this study had contact history with index subject in the same ward.ConclusionsIn conclusion, possible routes of TB transmission in a complex TB outbreak at LTCFs might be delineated by routine genotyping surveillance and regular health check-up.

【 授权许可】

CC BY   
© The Author(s). 2017