Risk of tuberculosis transmission by children in Hamburg, Germany - 04/03/23
![](/templates/common/images/mail.png)
Abstract |
Background |
Data from a prospective molecular-epidemiologic study (1997–2021) in Hamburg, Germany, were evaluated to assess the transmission risk of Mycobacterium tuberculosis complex (Mtbc) by children <15 years in a low-incidence setting.
Methods |
Isolates of Mtbc were genotyped whole genome sequencing, applying a core genome multilocus sequence typing scheme. Close contacts of culture-confirmed children were examined for latent Mtbc infections (LTBI) with particular focus on IGRA testing.
Results |
Out of 3154 culture-confirmed tuberculosis (TB) cases, 79 (2.5%) were children <15 years. Of those, 52 (58%) had pulmonary TB. Genotyping revealed that 35 of the 52 children (67%) were epidemiologically confirmed secondary cluster members; all of their source cases were adults. Six immigrant children presented without a presumed source case; their TB diagnoses came on average 48 weeks (interquartile range [IQR] 71) after their arrival in Germany. Three German-born children were determined to have been infected by adult relatives while visiting their parents' home country. Of the 317 children's close contacts tested with QuantiFERON-TB Gold-In Tube for LTBI, only 21 (6.6%) were positive. Absent a history of prior exposure or immigration from a high-incidence country, none of the contacts of younger (<10 years) TB-afflicted children was latently infected, whereas 2 older children infected 12 of their contacts, children and adults. During a mean observational period of 551 weeks (IQR 735) on average, no secondary TB cases appeared.
Conclusions |
Children with pulmonary TB disease, especially those aged below 10 years, rarely transmit Mtbc to their close contacts in a low-incidence setting.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The role of children <15 years in transmitting Mycobacterium tuberculosis (Mtbc) as verified by genotyping remains unclear. |
• | Transmission links of Mtbc were prospectively observed by whole genome sequencing (WGS) in Hamburg, Germany, since 1997. |
• | Transmissions by 52 children with culture-confirmed pulmonary tuberculosis (TB) were searched over a mean period of 551 weeks. |
• | Children with pulmonary TB disease, especially those aged below 10 years, rarely transmit Mtbc in a low-incidence setting. |
Keywords : Children, Tuberculosis, Transmission, Genotyping, Whole-genome sequencing, Epidemiology, IGRA
Plan
Vol 209
Article 107152- avril 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?