Tuberculosis Transmission by Patients with Smear-Negative Pulmonary Tuberculosis in a Large Cohort in The Netherlands

摘要: BACKGROUND: Sputum smear microscopy is commonly used for diagnosing tuberculosis (TB). Although patients with sputum smear-negative TB are less infectious than smear-positive TB, they also contribute to transmission. The objective of this study was determine the proportion transmission events caused by pulmonary in Netherlands. METHODS: All Netherlands culture-confirmed during period 1996-2004 were included study. Patients identical DNA fingerprints Mycobacterium isolates from samples clustered. first a cluster considered be index patients; all other have secondary cases. In addition, we examined sources conventional contact tracing. RESULTS: We analyzed 394 clusters total 1285 patients. On basis molecular linkage only, 12.6% cases attributable patient TB. relative rate among compared 0.24 (95% confidence interval, 0.20-0.30). Secondary an more frequently had status (odds ratio, 1.86; 95% 1.18-2.93), Conventional tracing revealed that 26 (6.2%) 417 sources, as identified Municipal Health Services, CONCLUSIONS: Netherlands, smear-negative, culture-positive responsible 13% Countries ample resources should expand their TB-control efforts include prevention