Skip to main content
Journal cover image

Exogenous reinfection of tuberculosis in a low-burden area.

Publication ,  Journal Article
Schiroli, C; Carugati, M; Zanini, F; Bandera, A; Di Nardo Stuppino, S; Monge, E; Morosi, M; Gori, A; Matteelli, A; Codecasa, L; Franzetti, F
Published in: Infection
December 2015

PURPOSE: Recurrence of tuberculosis (TB) can be the consequence of relapse or exogenous reinfection. The study aimed to assess the factors associated with exogenous TB reinfection. METHODS: Prospective cohort study based on the TB database, maintained at the Division of Infectious Diseases, Luigi Sacco Hospital (Milan, Italy). Time period: 1995-2010. INCLUSION CRITERIA: (1) ≥2 episodes of culture-confirmed TB; (2) cure of the first episode of TB; (3) availability of one Mycobacterium tuberculosis isolate for each episode. Genotyping of the M. tuberculosis strains to differentiate relapse and exogenous reinfection. Logistic regression analysis was used to assess the influence of risk factors on exogenous reinfections. RESULT: Of the 4682 patients with TB, 83 were included. Of these, exogenous reinfection was diagnosed in 19 (23 %). It was independently associated with absence of multidrug resistance at the first episode [0, 10 (0.01-0.95), p = 0.045] and with prolonged interval between the first TB episode and its recurrence [7.38 (1.92-28.32) p = 0.004]. However, TB relapses occurred until 4 years after the first episode. The risk associated with being foreign born, extrapulmonary site of TB, and HIV infection was not statistically significant. In the relapse and re-infection cohort, one-third of the patients showed a worsened drug resistance profile during the recurrent TB episode. CONCLUSIONS: Exogenous TB reinfections have been documented in low endemic areas, such as Italy. A causal association with HIV infection could not be confirmed. Relapses and exogenous reinfections shared an augmented risk of multidrug resistance development, frequently requiring the use of second-line anti-TB regimens.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Infection

DOI

EISSN

1439-0973

Publication Date

December 2015

Volume

43

Issue

6

Start / End Page

647 / 653

Location

Germany

Related Subject Headings

  • Young Adult
  • Tuberculosis
  • Recurrence
  • Prospective Studies
  • Mycobacterium tuberculosis
  • Middle Aged
  • Microbiology
  • Male
  • Italy
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schiroli, C., Carugati, M., Zanini, F., Bandera, A., Di Nardo Stuppino, S., Monge, E., … Franzetti, F. (2015). Exogenous reinfection of tuberculosis in a low-burden area. Infection, 43(6), 647–653. https://doi.org/10.1007/s15010-015-0759-9
Schiroli, Consuelo, Manuela Carugati, Fabio Zanini, Alessandra Bandera, Silvia Di Nardo Stuppino, Elisa Monge, Manuela Morosi, et al. “Exogenous reinfection of tuberculosis in a low-burden area.Infection 43, no. 6 (December 2015): 647–53. https://doi.org/10.1007/s15010-015-0759-9.
Schiroli C, Carugati M, Zanini F, Bandera A, Di Nardo Stuppino S, Monge E, et al. Exogenous reinfection of tuberculosis in a low-burden area. Infection. 2015 Dec;43(6):647–53.
Schiroli, Consuelo, et al. “Exogenous reinfection of tuberculosis in a low-burden area.Infection, vol. 43, no. 6, Dec. 2015, pp. 647–53. Pubmed, doi:10.1007/s15010-015-0759-9.
Schiroli C, Carugati M, Zanini F, Bandera A, Di Nardo Stuppino S, Monge E, Morosi M, Gori A, Matteelli A, Codecasa L, Franzetti F. Exogenous reinfection of tuberculosis in a low-burden area. Infection. 2015 Dec;43(6):647–653.
Journal cover image

Published In

Infection

DOI

EISSN

1439-0973

Publication Date

December 2015

Volume

43

Issue

6

Start / End Page

647 / 653

Location

Germany

Related Subject Headings

  • Young Adult
  • Tuberculosis
  • Recurrence
  • Prospective Studies
  • Mycobacterium tuberculosis
  • Middle Aged
  • Microbiology
  • Male
  • Italy
  • Humans