engleski

Tuberculosis outbreak in several psychiatric hospitals in Croatia caused by single M. tuberculosis strain

Since January 2007, 15-loci MIRU VNTR method is used to genotype M. tuberculosis strains in Croatia and additional loci are typed in case of MDR-TB or sub-typing of selected clusters. In period from 2007 to 2013, one of identified clusters was a cluster of 42 TB cases caused by M. tuberculosis strain of MLVA Mtbc 15 type 2470. Additional typing of auxiliary 9 loci didn’t identify any sub-clusters, since all strains were identified as MLVA Mtbc 9 type 85. Majority of patients in that cluster were suffering from mental illness and were at some point stationed in one of five psychiatric hospitals and one patient was a health care worker in a hospital where most TB cases were recorded. Additionally, patients’ records showed that several patients lived in assisted living facilities. Since some of patients were moved from other psychiatric hospitals, assisted living facilities and psychiatric wards of general hospitals to the psychiatric hospital with most TB cases, it can be presumed that this hospital was the central point of TB outbreak. Before genotyping results were available, the extent of this outbreak was unrecognized by classical epidemiology approach. Due to sensitive state of patients suffering from mental illness, diagnosis of TB was delayed causing a prolonged period of contagiousness. Also, crowded living conditions in these institutions probably contributed to the spread of TB.

tuberculosis; MIRU-VNTR; outbreak

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