       Document 0112
 DOCN  M9640112
 TI    Transmission of tuberculosis to close contacts of patients with
       multidrug-resistant tuberculosis.
 DT    9604
 AU    Kritski AL; Marques MJ; Rabahi MF; Vieira MA; Werneck-Barroso E;
       Carvalho CE; Andrade G de N; Bravo-de-Souza R; Andrade LM; Gontijo PP;
       Riley LW; Servico de Pneumologia, Hospital Clementino Fraga Filho,;
       Universidade Federal de Rio de Janeiro, Brazil.
 SO    Am J Respir Crit Care Med. 1996 Jan;153(1):331-5. Unique Identifier :
       AIDSLINE MED/96134242
 AB    Multidrug-resistant tuberculosis (MDRTB) has emerged as a major public
       health problem worldwide. To determine the incidence and risk factors
       associated with tuberculosis among contacts of MDRTB index cases, we
       studied human immunodeficiency virus-seronegative close contacts of 64
       culture-confirmed MDRTB patients in Rio de Janeiro, Brazil. Between
       March 1988 and July 1992, tuberculosis developed in 17 (7.8%) of 218
       previously healthy close contacts of 64 MDRTB index cases (1.6 cases per
       1,000-person-months of contact). Among strains of Mycobacterium
       tuberculosis isolated from 13 contacts of 12 index cases, six (46%) had
       susceptibility patterns identical to those of their index cases, four
       (31%) had different patterns of resistance, and three (23%) were
       susceptible to all drugs. Tuberculosis developed more frequently in male
       contacts (p < 0.05), persons > or = 15 yr of age (p < 0.05), nonwhites
       (p < 0.001), and persons not previously vaccinated with bacillus
       Calmette-Guerin (BCG) (p < 0.05). The association of BCG vaccination
       with decreased risk of disease was significant even when this variable
       was controlled (by Cox's regression analysis) for age, sex, race,
       purified protein derivative (PPD) status, and isoniazid prophylaxis. BCG
       vaccination appears to offer protection against tuberculosis during
       prolonged exposures to persons with MDRTB, which identifies a novel and
       specific indication of BCG use.
 DE    Adolescence  Adult  Age Factors  BCG Vaccine/ADMINISTRATION & DOSAGE
       Child  Child, Preschool  Comparative Study  Data Interpretation,
       Statistical  Female  Human  Infant  Infant, Newborn  Male  Middle Age
       Risk Factors  Sex Factors  Support, Non-U.S. Gov't  Support, U.S. Gov't,
       P.H.S.  Tuberculosis/PREVENTION & CONTROL/*TRANSMISSION  Tuberculosis,
       Multidrug-Resistant/PREVENTION & CONTROL/  *TRANSMISSION  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

