DNA Fingerprints From Mycobacterium tuberculosis Isolates of Patients Confined for Therapy Noncompliance Show Frequent Clustering
| Autor: | Laurie Sandman, James K. O'Brien, Barry N. Kreiswirth, Neil W. Schluger, William N. Rom |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Tuberculosis Antitubercular Agents Disease Critical Care and Intensive Care Medicine Disease cluster Disease Outbreaks Cohort Studies Patient Isolation Treatment Refusal Mycobacterium tuberculosis Internal medicine Epidemiology medicine Animals Humans Tuberculosis Pulmonary biology Transmission (medicine) business.industry Isoniazid Middle Aged biology.organism_classification medicine.disease DNA Fingerprinting Blotting Southern Immunology Female New York City Cardiology and Cardiovascular Medicine business Polymorphism Restriction Fragment Length medicine.drug Cohort study |
| Zdroj: | Chest. 112:387-392 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.112.2.387 |
| Popis: | Study objective To test the hypothesis that individuals chronically noncompliant with antituberculous chemotherapy are vectors for ongoing transmission of the disease in the community. Design Cohort study. Setting A large public hospital with a tuberculosis detention unit for patients with repeated and prolonged nonadherence to therapy. Patients Mycobacterium tuberculosis isolates from patients confined on the detention unit were obtained from the hospital's mycobacteriology laboratory. Interventions None Measurements and results A standardized IS6110-based Southern blot hybridization protocol was used to genotype M tuberculosis isolates recovered from patients confined on the detention unit at the hospital. Each DNA fingerprint pattern was compared with the IS6110-fingerprint database at the Public Health Research Institute Tuberculosis Center, which has archived fingerprint patterns from over 2,500 M tuberculosis isolates collected from New York City patients in the past 5 years. Eighty percent of available isolates from detained patients belonged to an identifiable DNA fingerprint cluster, suggesting an epidemiologic link between the detainees and other New York City tuberculosis patients. Conclusions Chronic noncompliance with therapy is associated with ongoing spread of tuberculosis in the community. Aggressive measures, including detention, for the small number of recalcitrant, noncompliant patients may interrupt a chain of transmission and contribute to a decline in the spread of tuberculosis in urban areas. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|