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[Exogenous re-infection in tuberculosis]
1Department of Respiratory Center, National Hospital Organization Nishi-Niigata Chuo National Hospital, Japan. tsuchiya@masa.go.jp
Kekkaku : [Tuberculosis]
|March 15, 2006
Summary
Exogenous reinfection, previously thought rare in immunocompetent tuberculosis patients, is increasingly recognized, especially with multidrug-resistant strains. Molecular typing confirms its occurrence, highlighting the need for strict infection control in healthcare settings.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Context:
- Tuberculosis (TB) reinfection was historically considered rare in immunocompetent individuals.
- Exogenous reinfection is well-documented in HIV-positive patients.
- Advances in molecular typing techniques like RFLP and spoligotyping have revealed higher rates of exogenous reinfection.
Purpose:
- To investigate the occurrence and characteristics of exogenous reinfection in tuberculosis patients.
- To analyze cases of multidrug-resistant tuberculosis (MDRTB) reinfection in a hospital setting.
- To review global and local data on TB exogenous reinfection and endogenous reactivation.
Summary:
- Molecular epidemiological tools, including RFLP and VNTR typing, demonstrate that exogenous reinfection with TB, including MDRTB, can occur even in immunocompetent individuals.
- While endogenous reactivation is more common in low-prevalence countries like Japan, exogenous reinfection is a significant concern in TB inpatient wards.
- Studies on Mycobacterium avium also show frequent reinfection and multiple infections, emphasizing the importance of understanding transmission routes.
Impact:
- Highlights the potential for nosocomial transmission of TB, including MDRTB.
- Underscores the critical need for enhanced infection control measures in TB hospitals for both patients and healthcare workers.
- Suggests a re-evaluation of TB relapse mechanisms, particularly in low-prevalence settings.