Outbreak of drug-resistant tuberculosis with second-generation transmission in a high school in California.
In spring 1993, four students in a high school were diagnosed with tuberculosis resistant to isoniazid, streptomycin, and ethionamide.
To investigate potential transmission of drug-resistant tuberculosis, a retrospective cohort study with case investigation and screening by tuberculin skin tests and symptom checks was conducted in a high school of approximately 1400 students.
Current and graduated high-school students were included in the investigation.
DNA fingerprinting of available isolates was performed.
Eighteen students with active tuberculosis were identified, Through epidemiologic and laboratory investigation, 13 cases were linked ; 8 entered 12th grade in fall 1993 ; 9 of 13 had positive cultures for Mycobéacterium taberculosis with isoniazid, streptomycin, and ethionamide resistance, and all 8 available isolates had identical DNA fingerprints.
No staff member had tuberculosis.
One student remained infectious for 29 months, from January 1991 to June 1993, and was the source case for the outbreak.
Another student was infectious for 5 months before diagnosis in May 1993 and was a treatment failure in February 1994 with development of rifampin and ethambutol resistance in addition to isoniazid, streptomycin, and ethionamide.
In the fall 1993 screening, 292 of 1263 (23%) students tested had a positive tuberculin skin test. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Poumon, Epidémie, Résistance traitement, Antituberculeux, Milieu scolaire, Epidémiologie, Isoniazide, Ethionamide, Streptomycine, Transmission, Homme, Chimiothérapie, Traitement, Aminoglycoside, Appareil respiratoire pathologie, Poumon pathologie
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Lung, Epidemic, Negative therapeutic reaction, Antituberculous agent, School environment, Epidemiology, Isoniazid, Ethionamide, Streptomycin, Transmission, Human, Chemotherapy, Treatment, Aminoglycoside, Respiratory disease, Lung disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0090821
Code Inist : 002B05B02O. Création : 14/05/1998.