Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience
Abstract Background Residents 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...
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BMC
2017-06-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-017-2526-2 |
| _version_ | 1819229103946989568 |
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| author | Wen-Cheng Chao Pei-Chun Chuang Don-Han Wu Chieh-Liang Wu Po-Yu Liu Chi-Chang Shieh Ruwen Jou |
| author_facet | Wen-Cheng Chao Pei-Chun Chuang Don-Han Wu Chieh-Liang Wu Po-Yu Liu Chi-Chang Shieh Ruwen Jou |
| author_sort | Wen-Cheng Chao |
| collection | DOAJ |
| description | Abstract Background Residents 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. Methods All 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. Results A 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. Conclusions In 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. |
| first_indexed | 2024-12-23T11:07:52Z |
| format | Article |
| id | doaj.art-4edd66f64dc44ab8a6988e06b909bcf9 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-23T11:07:52Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-4edd66f64dc44ab8a6988e06b909bcf92022-12-21T17:49:26ZengBMCBMC Infectious Diseases1471-23342017-06-011711910.1186/s12879-017-2526-2Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experienceWen-Cheng Chao0Pei-Chun Chuang1Don-Han Wu2Chieh-Liang Wu3Po-Yu Liu4Chi-Chang Shieh5Ruwen Jou6Department of Medical Research, Taichung Veterans General HospitalReference Laboratory of Mycobacteriology, Tuberculosis Research Center, Centers for Disease ControlDepartment of Internal Medicine, Taichung Veterans General Hospital Chiayi branchDepartment of Internal Medicine, Taichung Veterans General HospitalCenter for Quality Management, Taichung Veterans General HospitalInstitute of Clinical Medicine, National Cheng Kung University Medical CollegeReference Laboratory of Mycobacteriology, Tuberculosis Research Center, Centers for Disease ControlAbstract Background Residents 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. Methods All 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. Results A 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. Conclusions In 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.http://link.springer.com/article/10.1186/s12879-017-2526-2TuberculosisGenotypingTransmissionLong-term care facilityOutbreak |
| spellingShingle | Wen-Cheng Chao Pei-Chun Chuang Don-Han Wu Chieh-Liang Wu Po-Yu Liu Chi-Chang Shieh Ruwen Jou Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience BMC Infectious Diseases Tuberculosis Genotyping Transmission Long-term care facility Outbreak |
| title | Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience |
| title_full | Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience |
| title_fullStr | Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience |
| title_full_unstemmed | Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience |
| title_short | Using genotyping to delineate tuberculosis transmission in long-term care facilities: single facility 4-year experience |
| title_sort | using genotyping to delineate tuberculosis transmission in long term care facilities single facility 4 year experience |
| topic | Tuberculosis Genotyping Transmission Long-term care facility Outbreak |
| url | http://link.springer.com/article/10.1186/s12879-017-2526-2 |
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