Chongguang Yang1, Xin Shen2, Ying Peng3, Rushu Lan4, Yuling Zhao5, Bo Long6, Tao Luo1, Guomei Sun1, Xia Li1, Ke Qiao1, Xiaohong Gui2, Jie Wu2, Jiying Xu5, Fabin Li3, Dingyue Li6, Feiying Liu4, Mei Shen2, Jianjun Hong7, Jian Mei2, Kathryn DeRiemer8, Qian Gao1. 1. Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Institutes of Biomedical Sciences and Institute of Medical Microbiology, Shanghai Medical College, Fudan University. 2. Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention. 3. Tuberculosis Control Center of Heilongjiang Province, Harbin. 4. Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning. 5. Henan Center for Disease Control and Prevention, Zhengdong New District, Zhengzhou. 6. Sichuan Center for Disease Control and Prevention, Chengdu. 7. Department of Tuberculosis Control, Songjiang District Center for Disease Control and Prevention, Shanghai, People's Republic of China. 8. School of Medicine, University of California, Davis.
Abstract
BACKGROUND: Understanding the transmission of Mycobacterium tuberculosis is essential for the development of efficient tuberculosis control strategies. China has the second-largest tuberculosis burden in the world. Recent transmission and infection with M. tuberculosis, particularly drug-resistant strains, may account for many new tuberculosis cases. METHODS: We performed a population-based molecular epidemiologic study of pulmonary tuberculosis in China during 1 July 2009 to 30 June 2012. We defined clusters as cases with identical variable number tandem repeat genotype patterns and identified the risk factors associated with clustering, by logistic regression. Relative transmission rates were estimated by the sputum smear status and drug susceptibility status of tuberculosis patients. RESULTS: Among 2274 culture-positive tuberculosis patients with genotyped isolates, there were 705 (31.0%) tuberculosis patients in 287 clusters. Multidrug-resistant (MDR) tuberculosis (adjusted odds ratio [aOR], 1.86; 95% confidence interval [CI], 1.25-2.63) and infection with a Beijing family strain (aOR, 1.56; 95% CI, 1.23-2.96) were associated with clustering. Eighty-four of 280 (30.0%) clusters had a putative source case that was sputum smear negative, and 30.6% of their secondary cases were attributed to transmission by sputum smear-negative patients. The relative transmission rate for sputum smear negative compared with sputum smear-positive patients was 0.89 (95% CI, .68-1.10), and was 1.51 (95% CI, 1.00-2.24) for MDR tuberculosis vs drug-susceptible tuberculosis. CONCLUSIONS: Recent transmission of M. tuberculosis, including MDR strains, contributes substantially to tuberculosis disease in China. Sputum smear-negative cases were responsible for at least 30% of the secondary cases. Interventions to reduce the transmission of M. tuberculosis should be implemented in China.
BACKGROUND: Understanding the transmission of Mycobacterium tuberculosis is essential for the development of efficient tuberculosis control strategies. China has the second-largest tuberculosis burden in the world. Recent transmission and infection with M. tuberculosis, particularly drug-resistant strains, may account for many new tuberculosis cases. METHODS: We performed a population-based molecular epidemiologic study of pulmonary tuberculosis in China during 1 July 2009 to 30 June 2012. We defined clusters as cases with identical variable number tandem repeat genotype patterns and identified the risk factors associated with clustering, by logistic regression. Relative transmission rates were estimated by the sputum smear status and drug susceptibility status of tuberculosispatients. RESULTS: Among 2274 culture-positive tuberculosispatients with genotyped isolates, there were 705 (31.0%) tuberculosispatients in 287 clusters. Multidrug-resistant (MDR) tuberculosis (adjusted odds ratio [aOR], 1.86; 95% confidence interval [CI], 1.25-2.63) and infection with a Beijing family strain (aOR, 1.56; 95% CI, 1.23-2.96) were associated with clustering. Eighty-four of 280 (30.0%) clusters had a putative source case that was sputum smear negative, and 30.6% of their secondary cases were attributed to transmission by sputum smear-negative patients. The relative transmission rate for sputum smear negative compared with sputum smear-positive patients was 0.89 (95% CI, .68-1.10), and was 1.51 (95% CI, 1.00-2.24) for MDR tuberculosis vs drug-susceptible tuberculosis. CONCLUSIONS: Recent transmission of M. tuberculosis, including MDR strains, contributes substantially to tuberculosis disease in China. Sputum smear-negative cases were responsible for at least 30% of the secondary cases. Interventions to reduce the transmission of M. tuberculosis should be implemented in China.
Authors: E M Lohmann; B F P J Koster; S le Cessie; M P Kamst-van Agterveld; D van Soolingen; S M Arend Journal: Int J Tuberc Lung Dis Date: 2012-09-07 Impact factor: 2.373
Authors: Patrick K Moonan; Larry D Teeter; Katya Salcedo; Smita Ghosh; Shama D Ahuja; Jennifer Flood; Edward A Graviss Journal: Lancet Infect Dis Date: 2013-06-05 Impact factor: 25.071
Authors: Guang Xue He; Hai Ying Wang; Martien W Borgdorff; Dick van Soolingen; Marieke J van der Werf; Zhi Min Liu; Xue Zheng Li; Hui Guo; Yan Lin Zhao; Jay K Varma; Christopher P Tostado; Susan van den Hof Journal: Emerg Infect Dis Date: 2011-10 Impact factor: 6.883
Authors: Sara C Auld; N Sarita Shah; Barun Mathema; Tyler S Brown; Nazir Ismail; Shaheed Vally Omar; James C M Brust; Kristin N Nelson; Salim Allana; Angela Campbell; Koleka Mlisana; Pravi Moodley; Neel R Gandhi Journal: Eur Respir J Date: 2018-10-18 Impact factor: 16.671
Authors: N Sarita Shah; Sara C Auld; James C M Brust; Barun Mathema; Nazir Ismail; Pravi Moodley; Koleka Mlisana; Salim Allana; Angela Campbell; Thuli Mthiyane; Natashia Morris; Primrose Mpangase; Hermina van der Meulen; Shaheed V Omar; Tyler S Brown; Apurva Narechania; Elena Shaskina; Thandi Kapwata; Barry Kreiswirth; Neel R Gandhi Journal: N Engl J Med Date: 2017-01-19 Impact factor: 91.245