Epidemiological investigation of a rifampicin-resistant tuberculosis outbreak in a middle school in Jiangsu Province

WU Ji-zhou; FU Jian; WANG Jian-ming; LIU Qiao; LU Feng

doi:10.16462/j.cnki.zhjbkz.2022.11.004

Volume 26 Issue 11

Nov. 2022

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WU Ji-zhou, FU Jian, WANG Jian-ming, LIU Qiao, LU Feng. Epidemiological investigation of a rifampicin-resistant tuberculosis outbreak in a middle school in Jiangsu Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(11): 1259-1263. doi: 10.16462/j.cnki.zhjbkz.2022.11.004

Citation:

WU Ji-zhou, FU Jian, WANG Jian-ming, LIU Qiao, LU Feng. Epidemiological investigation of a rifampicin-resistant tuberculosis outbreak in a middle school in Jiangsu Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(11): 1259-1263. doi: 10.16462/j.cnki.zhjbkz.2022.11.004

Citation:

WU Ji-zhou, FU Jian, WANG Jian-ming, LIU Qiao, LU Feng. Epidemiological investigation of a rifampicin-resistant tuberculosis outbreak in a middle school in Jiangsu Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(11): 1259-1263. doi: 10.16462/j.cnki.zhjbkz.2022.11.004

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Epidemiological investigation of a rifampicin-resistant tuberculosis outbreak in a middle school in Jiangsu Province

doi: 10.16462/j.cnki.zhjbkz.2022.11.004

WU Ji-zhou¹,
FU Jian²,
WANG Jian-ming¹,
LIU Qiao^{3
,
,},
LU Feng^{2
,
,}

1.
Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 210000, China
2.
Department of Tuberculosis, Center for Disease Control and Prevention of Nantong City, Nantong 226000, China
3.
Department of Chronic Communicable Disease, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China

Funds:

National Natural Science Foundation of China 82003516

General Medical Research Project of Jiangsu Commission Health M2020020

More Information

Corresponding author: LIU Qiao, E-mail: liuqiaonjmu@163.com; LU Feng, E-mail: lufengntcdc@163.com
Received Date: 2022-02-10
Rev Recd Date: 2022-04-03

Available Online: 2022-12-21

Publish Date: 2022-11-10

Abstract

Abstract

Objective To describe the characteristics and epidemiology of a rifampicin-resistant tuberculosis outbreak in a middle school of Jiangsu Province, and provide suggestions for the prevention and control of the school tuberculosis. Methods Combination of field epidemiology investigation and laboratory examinations (including whole-genome sequencing) were taken in this tuberculosis outbreak. Close contacts were screened for tuberculosis suspected symptoms, tuberculin skin test (TST), and chest X-ray. Bacteriological tests, including sputum smear, sputum culture, traditional drug susceptibility test and GeneXpert MTB/RIF test were carried out for contacts with abnormal screening results. Meanwhile, whole-genome sequencing was performed for culture-positive strains. Results From June 24, 2019 to July 7, 2019, a total of 352 close contacts were screened in two rounds contacts screening. The strongly positive rate of TST(average diameter ≥15 mm) was 3.69% (13/352) and the abnormal rate of chest X-ray was 3.97% (14/352). A total of 12 patients with pulmonary tuberculosis were diagnosed, including 6 bacteriological positive patients, and 6 bacteriological negative patients. GeneXpert MTB/RIF test detected 6 MTB positive also with rifampicin resistance. The traditional drug susceptibility test of the culture-positive strains of four tuberculosis patients showed that they were all resistant to rifampicin. Whole genome sequencing data indicated that all 4 culture-positive strains belonged to L2 type, with the same mutation and drug resistance site. Conclusions Based on the field and molecular epidemiological results, this school rifampicin-resistant tuberculosis was a homologous outbreak. Compared with traditional anti-TB drug susceptibility test, whole-genome sequencing is recommended for tuberculosis outbreak investigation due to its high-speed and accuracy.
- Tuberculosis,
- School outbreak,
- Whole genome sequencing,
- Rifampicin resistance

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References(22)

References

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