Objective: To understand the recent transmission of Mycobacterium tuberculosis (MTB), and to identify the influencing factors of recent transmission among pulmonary tuberculosis (TB) patients in Jing'an district, Shanghai. Methods: The genotypes and drug resistances of MTB isolated from TB patients registered in the TB designated hospitals in Jing'an district during 2010-2015 were analyzed through 12-loci Mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR)(QUB11b, QUB18, Mtub21, Miru26, QUB26, Mtub04, Miru31, Miru40, VNTR2372, VNTR3820, 3232, 4120), and tested for drug susceptibility as well. With the results of field epidemiological investigation, univariate and multivariate analyses were performed to analyze the distribution of the clusters and influencing factors on recent transmission. Results: This study enrolled 80 TB patients, 23 (28.75%) had a resistance to at least one anti-TB drug, and the prevalence of multidrug-resistant tuberculosis (MDR-TB) was 16.25%. A total of 65 genotypes were identified with 58 (72.50%, 58/80) being unique and 7 clusters with 2-10 isolated in each cluster. The proportion of clustering was 27.50% (22/80). Results from the multivariate analysis revealed that multidrug- resistance (OR=35.799, 95%CI: 4.239-302.346) and having comorbidity with TB (OR=7.695, 95%CI: 1.421-41.658) were independently associated with the clustering, which suggesting a recent transmission. The field investigation to the clustered cases proved that the patients in two clusters had epidemiological links, one was between family members, and the other contained 10 MDR-TB patients with 9 knowing each other which have a definite connection and 1 having the possible connection with them. Conclusion: Recent transmission of tuberculosis happened among TB patients in Jing'an district, with high risks among the MDR-TB patients.
China ; Cluster Analysis ; Genotype ; Humans ; Mycobacterium tuberculosis/isolation & purification* ; Tuberculosis ; Tuberculosis, Multidrug-Resistant/transmission* ; Tuberculosis, Pulmonary/transmission*

PURPOSE: In order to prevent tuberculosis transmission early, it is important to diagnose and treat tuberculosis infection by investigating people who have contact with patients with active tuberculosis. METHODS: From July 2014 to June 2017, the intrafamilial childhood contacts of the patients who were diagnosed with active tuberculosis at Chungnam National University Hospital were investigated for the presence of tuberculosis infection. We also retrospectively analyzed the treatment status of children treated with latent tuberculosis infection (LTBI) during the same period. RESULTS: Among the 269 children who had intrafamilial contact with active tuberculosis patient, 20 (7.4%) did not receive any screening. At the first screening, one (0.4%) was diagnosed with pulmonary tuberculosis, seven (2.8%) had a previous history of tuberculosis infection, and 42 patients (16.9%) were diagnosed with LTBI. At the second screening, 29 patients (11.6%) were diagnosed with LTBI, and 61 patients did not finish the investigation. Only 188 (69.9%) out of 269 patients completed the investigation. Ninety patients received treatment for LTBI and 83 patients (92.2%) completed the treatment, of which 18 patients had side effects such as rash, fatigue, and gastrointestinal symptoms. However, there were no serious side effects requiring treatment discontinuation. CONCLUSIONS: The completion rate of childhood tuberculosis contact investigation was low, but the completion rate of LTBI treatment was high in children without serious side effects. In order to prevent and manage the spread of tuberculosis, active private-public partnership efforts and education of the patient and guardian are needed.
Child ; Chungcheongnam-do ; Disease Transmission, Infectious ; Education ; Exanthema ; Fatigue ; Humans ; Latent Tuberculosis ; Mass Screening ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Foundry workers are known to be exposed to silica and have an increased risk of silicosis. There are also reports that state these foundry workers were associated with asbestos-related change in the X-ray results of the lungs. This report discusses a case of localized asbestosis developed in a foundry worker who worked in 12 Korean foundries. CASE REPORT: A 49-year-old man who worked at molding and melting for 30 years, presented with sore throat, cough and yellow sputum for 1 month. From physical and clinical examination, pulmonary tuberculosis was highly suspicious; therefore, he was medicated for 6 months. After tuberculosis medication, the radiological finding was reactivation of tuberculosis, and an asbestos body was detected at a transbronchial lung biopsy. During an operation, operators found multiple palpable masses and bullae localized in the right upper lobe (RUL) and performed right upper lobectomy and right middle lobe wedge resection. Using hematoxylin-eosin stain and iron stain, we could detect asbestos bodies by light microscopy. We analyzed the asbestos fiber burden in dry lung tissue by transmission electron microscopy with energy dispersive X-ray spectrometer (TEM-EDX). The fiber type was chrysotile and the fiber burden was 23.26x106 fiber/g dry lung. DISCUSSION: This case study of a foundry worker with localized asbestosis is uncommon in Korea. We found an occupational relationship between the foundry worker and localized asbestosis through various investigative techniques such as measurements taken at his working environment, clinical, radiological and pathological examination of the foundry worker and mineralogical examination of the asbestos fiber.
Asbestos ; Asbestos, Serpentine ; Asbestosis ; Biopsy ; Blister ; Cough ; Freezing ; Fungi ; Humans ; Investigative Techniques ; Iron ; Korea ; Light ; Lung ; Microscopy ; Microscopy, Electron, Transmission ; Middle Aged ; Pharyngitis ; Silicon Dioxide ; Silicosis ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Foundry workers are known to be exposed to silica and have an increased risk of silicosis. There are also reports that state these foundry workers were associated with asbestos-related change in the X-ray results of the lungs. This report discusses a case of localized asbestosis developed in a foundry worker who worked in 12 Korean foundries. CASE REPORT: A 49-year-old man who worked at molding and melting for 30 years, presented with sore throat, cough and yellow sputum for 1 month. From physical and clinical examination, pulmonary tuberculosis was highly suspicious; therefore, he was medicated for 6 months. After tuberculosis medication, the radiological finding was reactivation of tuberculosis, and an asbestos body was detected at a transbronchial lung biopsy. During an operation, operators found multiple palpable masses and bullae localized in the right upper lobe (RUL) and performed right upper lobectomy and right middle lobe wedge resection. Using hematoxylin-eosin stain and iron stain, we could detect asbestos bodies by light microscopy. We analyzed the asbestos fiber burden in dry lung tissue by transmission electron microscopy with energy dispersive X-ray spectrometer (TEM-EDX). The fiber type was chrysotile and the fiber burden was 23.26x106 fiber/g dry lung. DISCUSSION: This case study of a foundry worker with localized asbestosis is uncommon in Korea. We found an occupational relationship between the foundry worker and localized asbestosis through various investigative techniques such as measurements taken at his working environment, clinical, radiological and pathological examination of the foundry worker and mineralogical examination of the asbestos fiber.
Asbestos ; Asbestos, Serpentine ; Asbestosis ; Biopsy ; Blister ; Cough ; Freezing ; Fungi ; Humans ; Investigative Techniques ; Iron ; Korea ; Light ; Lung ; Microscopy ; Microscopy, Electron, Transmission ; Middle Aged ; Pharyngitis ; Silicon Dioxide ; Silicosis ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

Student contacts of tuberculosis (TB) cases are susceptible to latent tuberculosis infection (LTBI), and chemo-prophylaxis can reduce the risk of active TB among them. This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment. A total of 560 students contacts were included in the investigation. The extent of contact was categorized from high to low (4 levels) with 12.9% of the students being close contacts. About 87.0% of the students were willing to receive chemo-prophylaxis if diagnosed with, LTBI, whereas 73 students declined. Students with a higher level of knowledge about TB (aOR = 1.11) or close contact with TB patients (aOR = 4.30) were more likely to accept treatment. To conclude, education regarding TB transmission is necessary. Moreover, LTBI detection should be integrated into the current school-based TB contact investigation.
Adolescent ; Adult ; Antitubercular Agents ; administration & dosage ; therapeutic use ; China ; epidemiology ; Contact Tracing ; Female ; Humans ; Latent Tuberculosis ; drug therapy ; epidemiology ; Male ; Students ; Tuberculosis, Pulmonary ; drug therapy ; epidemiology ; prevention & control ; transmission ; Universities ; Young Adult