Investigating a tuberculosis cluster among Filipino health care workers in a low-incidence country.
Int J Tuberc Lung Dis
; 22(3): 252-257, 2018 03 01.
Article
en En
| MEDLINE
| ID: mdl-29471901
ABSTRACT
SETTING:
Nearly 8% of adult tuberculosis (TB) cases in England, Wales and Northern Ireland (EW&NI) occur among health care workers (HCWs), the majority of whom are from high TB incidence countries.OBJECTIVES:
To determine if a TB cluster containing multiple HCWs was due to nosocomial transmission.METHODS:
A cluster of TB cases notified in EW&NI from 2009 to 2014, with indistinguishable 24-locus mycobacterial interspersed repetitive unit-variable number of tandem repeats (MIRU-VNTR) profiles, was identified through routine national cluster review. Cases were investigated to identify epidemiological links, and occupational health (OH) information was collected for HCW cases. To further discriminate strains, typing of eight additional loci was conducted.RESULTS:
Of the 53 cases identified, 22 were HCWs. The majority (n = 43), including 21 HCWs, were born in the Philippines. Additional typing split the cluster into three subclusters and seven unique strains. No epidemiological links were identified beyond one household and a common residential area. HCWs in this cluster received no or inadequate OH assessment.CONCLUSIONS:
The MIRU-VNTR profile of this cluster probably reflects common endemic strains circulating in the Philippines, with reactivation occurring in the UK. Furthermore, 32-locus typing showed that 24-locus MIRU-VNTR failed to distinguish strain diversity. The lack of OH assessment indicates that latent tuberculous infection could have been identified and treated, thereby preventing active cases from occurring.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
3_ND
Problema de salud:
3_neglected_diseases
/
3_tuberculosis
Asunto principal:
Tuberculosis
/
Personal de Salud
/
Mycobacterium tuberculosis
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Child
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Child, preschool
/
Humans
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Infant
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Middle aged
/
Newborn
País/Región como asunto:
Asia
/
Europa
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Año:
2018
Tipo del documento:
Article