Abstract
Recurrent tuberculosis is an important indicator of the effectiveness of tuberculosis control and can occur by relapse or exogenous reinfection. We conducted a retrospective cohort study on all bacteriologically confirmed tuberculosis cases that were successfully treated between 2000 and 2012 in Shanghai, an urban area with a high number but a low prevalence rate of tuberculosis cases and a low prevalence of HIV infection. Genotyping the Mycobacterium tuberculosis from clinical isolates was used to distinguish between relapse and reinfection. In total, 5.3% (710/13,417) of successfully treated cases had a recurrence, a rate of 7.55 (95% CI 7.01–8.13) episodes per 1000 person-years, more than 18 times the rate of tuberculosis in the general population. Patients who were male, age 30–59, retreatment cases, had cavitation, diabetes, drug-resistant or multidrug-resistant tuberculosis in their initial episode of tuberculosis, were at high risk for a recurrence. Among 141 recurrent cases that had paired isolates, 59 (41.8%) had different genotypes, indicating reinfection with a different strain. Patients who completed treatment were still at high risk of another episode of tuberculosis and exogenous reinfection contributed a significant proportion of the recurrent tuberculosis cases. Targeted control strategies are needed to prevent new tuberculosis infections in this setting.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 97-104 |
| Number of pages | 8 |
| Journal | Tuberculosis |
| Volume | 103 |
| DOIs | |
| State | Published - Mar 1 2017 |
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Keywords
- China
- Exogenous reinfection
- Recurrence
- Tuberculosis
ASJC Scopus subject areas
- Microbiology
- Immunology
- Microbiology (medical)
- Infectious Diseases
Cite this
Recurrent tuberculosis in an urban area in China : Relapse or exogenous reinfection? / Shen, Xin; Yang, Chongguang; Wu, Jie; Lin, Senlin; Gao, Xu; Wu, Zheyuan; Tian, Jiyun; Gan, Mingyu; Luo, Tao; Wang, Lili; Yu, Chenlei; Mei, Jian; Pan, Qichao; DeRiemer, Kathryn; Yuan, Zheng An; Gao, Qian.
In: Tuberculosis, Vol. 103, 01.03.2017, p. 97-104.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Recurrent tuberculosis in an urban area in China
T2 - Relapse or exogenous reinfection?
AU - Shen, Xin
AU - Yang, Chongguang
AU - Wu, Jie
AU - Lin, Senlin
AU - Gao, Xu
AU - Wu, Zheyuan
AU - Tian, Jiyun
AU - Gan, Mingyu
AU - Luo, Tao
AU - Wang, Lili
AU - Yu, Chenlei
AU - Mei, Jian
AU - Pan, Qichao
AU - DeRiemer, Kathryn
AU - Yuan, Zheng An
AU - Gao, Qian
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Recurrent tuberculosis is an important indicator of the effectiveness of tuberculosis control and can occur by relapse or exogenous reinfection. We conducted a retrospective cohort study on all bacteriologically confirmed tuberculosis cases that were successfully treated between 2000 and 2012 in Shanghai, an urban area with a high number but a low prevalence rate of tuberculosis cases and a low prevalence of HIV infection. Genotyping the Mycobacterium tuberculosis from clinical isolates was used to distinguish between relapse and reinfection. In total, 5.3% (710/13,417) of successfully treated cases had a recurrence, a rate of 7.55 (95% CI 7.01–8.13) episodes per 1000 person-years, more than 18 times the rate of tuberculosis in the general population. Patients who were male, age 30–59, retreatment cases, had cavitation, diabetes, drug-resistant or multidrug-resistant tuberculosis in their initial episode of tuberculosis, were at high risk for a recurrence. Among 141 recurrent cases that had paired isolates, 59 (41.8%) had different genotypes, indicating reinfection with a different strain. Patients who completed treatment were still at high risk of another episode of tuberculosis and exogenous reinfection contributed a significant proportion of the recurrent tuberculosis cases. Targeted control strategies are needed to prevent new tuberculosis infections in this setting.
AB - Recurrent tuberculosis is an important indicator of the effectiveness of tuberculosis control and can occur by relapse or exogenous reinfection. We conducted a retrospective cohort study on all bacteriologically confirmed tuberculosis cases that were successfully treated between 2000 and 2012 in Shanghai, an urban area with a high number but a low prevalence rate of tuberculosis cases and a low prevalence of HIV infection. Genotyping the Mycobacterium tuberculosis from clinical isolates was used to distinguish between relapse and reinfection. In total, 5.3% (710/13,417) of successfully treated cases had a recurrence, a rate of 7.55 (95% CI 7.01–8.13) episodes per 1000 person-years, more than 18 times the rate of tuberculosis in the general population. Patients who were male, age 30–59, retreatment cases, had cavitation, diabetes, drug-resistant or multidrug-resistant tuberculosis in their initial episode of tuberculosis, were at high risk for a recurrence. Among 141 recurrent cases that had paired isolates, 59 (41.8%) had different genotypes, indicating reinfection with a different strain. Patients who completed treatment were still at high risk of another episode of tuberculosis and exogenous reinfection contributed a significant proportion of the recurrent tuberculosis cases. Targeted control strategies are needed to prevent new tuberculosis infections in this setting.
KW - China
KW - Exogenous reinfection
KW - Recurrence
KW - Tuberculosis
UR - http://www.scopus.com/inward/record.url?scp=85011886989&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85011886989&partnerID=8YFLogxK
U2 - 10.1016/j.tube.2017.01.007
DO - 10.1016/j.tube.2017.01.007
M3 - Article
C2 - 28237039
AN - SCOPUS:85011886989
VL - 103
SP - 97
EP - 104
JO - Tuberculosis
JF - Tuberculosis
SN - 1472-9792
ER -