耐药肺结核患者密切接触者结核分枝杆菌潜伏感染危险因素分析OA北大核心CSTPCD

Objective:To explore the situation and risk factors of latent tuberculosis infection(LTBI)in close contacts of drug-resistant pulmonary tuberculosis patients.Methods:Using a prospective research method,306 close contacts of 154 drug-resistant pulmonary tuberculosis(including rifampicin resistant pulmonary tuberculosis and multidrug-resistant pulmonary tuberculosis)patients admitted to the Wenzhou Central Hospital from July 2020 to January 2022 were selected as the study subjects.Collected information included the sociodemographic characteristics,history of BCG vaccination,disease history,and contact with indicated cases of the research subjects;in addition,HIV antibody screening,chest CT scan,T-SPOT.TB and/or PPD test,etc.were conducted.The LTBI situation of the research subjects was investigated,and logistic regression models were used to analyze the influencing factors of their occurrence of LTBI.Results:The LTBI rate among the study subjects was 18.6％(57/306).The results of multivariate analysis showed that,for the close contacts,aged ≥ 40 years,female,physical workers,and those with clinical symptoms such as cough and sputum in the indication case were at a higher risk of developing LTBI(OR(95％CI)values of 6.501(1.371-30.827),2.961(1.472-5.956),2.716(1.368-5.391),3.100(1.278-7.521),and 3.065(1.336-7.031),respectively);family monthly income≥RMB 5000 yuan was a protective factor for close contacts to develop LTBI(OR(95％CI)=0.308(0.156-0.607)).Conclusion:Close contacts of drug-resistant pulmonary tuberculosis patients have a higher LTBI rate.Elderly,female,physically active workers,low-income individuals,as well as close contacts with relapsed drug-resistant pulmonary tuberculosis patients and drug-resistant pulmonary tuberculosis patients with clinical symptoms such as cough and sputum,are high-risk population for latent infection.