上海市普陀区结核菌近期传播特征及影响因素研究

发布时间：2018-02-08 20:16

本文关键词： 结核肺传播结核分支杆菌基因型分子流行病学　出处：《环境与职业医学》2014年05期 　论文类型：期刊论文

【摘要】：[目的]了解上海市普陀区结核病近期传播特征及其影响因素,为制定具有针对性的结核病控制策略提供依据。[方法]对2009—2010年普陀区结核病定点医院登记的结核病患者中分离获得的结核分枝杆菌进行基因分型,利用可变数目串联重复序列(VNTR)基因分型方法识别结核菌基因型的"成簇性"和"独特性",通过流行病学调查描述结核病患者结核菌的成簇性分布特征,分析人口学特征、临床特点、社会学特征对结核病传播的影响。[结果]本次研究共纳入180例患者,其中感染北京基因型菌株患者153例(85.00%)。有48例患者感染的菌株具有成簇性,形成20个簇,总成簇率为26.67%(48/180),其余132例患者感染的菌株基因型表现为独特性。有65.00%(13/20)的簇包含户籍患者和非户籍患者。同簇病例中有2簇为家庭内接触;有8簇居住在同一社区。30～59岁年龄组(30～岁/18～岁:OR=3.783,95%CI:1.421～10.074)和北京基因型菌株(北京株/非北京株OR=6.446,95%CI:1.446～28.731)更易成簇。[结论]普陀区结核病患者中存在一定比例的近期传播,户籍与非户籍患者存在混合传播。由于辖区结核病流行菌株为北京基因型,结合影响本区结核病传播的危险因素及非户籍人口特征,非户籍人口为本区结核病防控重点人群。
[Abstract]:[objective] to understand the characteristics of tuberculosis transmission and its influencing factors in Putuo District, Shanghai, China. [methods] Mycobacterium tuberculosis isolated from tuberculosis patients registered in designated hospitals of Putuo district from 2009 to 2010 was genotyped. The variable number tandem repeat (VNTR) genotyping method was used to identify the "clustering" and "uniqueness" of tuberculous bacteria genotypes. The characteristics of tuberculous bacilli were described by epidemiological investigation, and the demographic characteristics were analyzed. [results] A total of 180 patients were included in this study, of whom 153 were infected with Beijing genotypic strains. The total cluster rate was 26.67 / 180%, and the genotypes of the other 132 patients were unique. 65.0013 / 20) clusters included household registration patients and non-household registered patients. In the same cluster cases, 2 clusters were intra-family contacts. There are 8 clusters living in the same community. 30- / 18-year-old / 18-year-old / 18-year-old / 3.783- 95 CI: 1.421 / 10.074) and Beijing genotypic strains (Beijing / non-Beijing strain OR6.446 / 95CIW 1.446 / 28.731) are more easily clustered. [conclusion] there is a certain proportion of patients with tuberculosis in Putuo district who have recently transmitted tuberculosis. There is mixed transmission between household registration and non-household registration patients. Because the epidemic strains of tuberculosis in the district are Beijing genotype, combined with the risk factors affecting the transmission of tuberculosis in this district and the characteristics of non-household registered population, the non-household population is the key population of TB prevention and control in this district.
【作者单位】：普陀区疾病预防控制中心传染病控制科;普陀区卫生和计划生育委员会;上海市疾病预防控制中心结核病防治科;上海市防痨协会;
【基金】：科技部“十二五”科技重大专项课题(编号:2013 ZX10004903) 普陀区卫生系统自主创新科研资助项目(编号:普KW09206)
【分类号】：R521

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