{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T19:11:04Z","timestamp":1794337864630,"version":"4.9.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund\u2002Im Rahmen der Tuberkulosekontrolle und der End-TB-Strategie der WHO werden in Deutschland Kontaktpersonen von Tuberkulosepatienten auf eine m\u00f6gliche latente Tuberkulose-Infektion (LTBI) untersucht. Die Aktivierung einer LTBI tr\u00e4gt einen erheblichen Anteil der neugemeldeten Tuberkulose-F\u00e4lle in Niedrig-Inzidenz-L\u00e4ndern wie Deutschland bei. Deshalb ist es ein Ziel, F\u00e4lle von LTBI zu entdecken und durch chemopr\u00e4ventive Behandlung zuk\u00fcnftige, postprim\u00e4re, aktive Tuberkulosen zu verhindern. In Deutschland wird die Rate von LTBI unter Kontaktpersonen von an Tuberkulose Erkrankten nicht systematisch erfasst. Ziel der vorliegenden Arbeit ist es, diese Datenl\u00fccke f\u00fcr die Stadt K\u00f6ln zu schlie\u00dfen. Die TB-Inzidenz in K\u00f6ln betrug in den letzten Jahren ca. 9\/100\u200a000 Einwohner. Im Weiteren werden Risikofaktoren f\u00fcr eine LTBI beschrieben und die geltenden Einschlusskriterien f\u00fcr die Umgebungsuntersuchung bei Tuberkulose unter Routinebedingungen in Deutschland reevaluiert. <\/jats:p><jats:p>\n          Material und Methoden\u2002Die retrospektive Kohortenstudie untersucht f\u00fcr die Periode 07\/2012 bis 12\/2016 die Rate an LTBI-Diagnosen unter Kontaktpersonen von an Lungentuberkulose erkrankten Personen im Zust\u00e4ndigkeitsbereich des K\u00f6lner Gesundheitsamtes sowie Faktoren, die das LTBI-Infektionsrisiko von Kontaktpersonen erh\u00f6hen. Im Rahmen der Studie wurden die Risikofaktoren Geschlecht, Alter, Art der Exposition (h\u00e4usliches Umfeld\/Arbeitsplatz) sowie die Kontagiosit\u00e4t des Indexpatienten auf ihren Einfluss auf das Infektionsrisiko bei latenter Tuberkulose ber\u00fccksichtigt.<\/jats:p><jats:p>Die Diagnose der latenten Tuberkulose wurde bei einem positiven Interferon-gamma Release Assay und fehlenden Zeichen einer aktiven Tuberkulose gestellt. In die Untersuchung wurden Kontaktpersonen eingeschlossen, die kumulativ eine zuvor definierte Mindestgesamtkontaktzeit zu einem Tuberkulosepatienten hatten, zum Untersuchungszeitpunkt mindestens 5 Jahre alt und in K\u00f6ln gemeldet waren. <\/jats:p><jats:p>Die statistische Auswertung erfolgte deskriptiv als absolute und relative H\u00e4ufigkeit bei einem Signifikanzniveau von p\u200a\u2264\u200a0,05. Die analytische Auswertung wurde mit univariater und multivariater logistischer Regression durchgef\u00fchrt. Die Variablen, die sich in der Deskription als signifikant herausgestellt hatten, wurden zun\u00e4chst univariat auf einen signifikanten Einfluss gepr\u00fcft und bei statistisch signifikantem Ergebnis in das multivariate Modell eingeschlossen.<\/jats:p><jats:p>\n          Ergebnisse\u2002Von insgesamt 3862 IGRA-Untersuchungen unter Kontaktpersonen erf\u00fcllten 2834 F\u00e4lle die Einschlusskriterien. Im Median wurden 7 Kontaktpersonen pro Indexpatient gemeldet. 12,5\u200a% des Untersuchungskollektives wurden positiv auf LTBI getestet. Bei Kontaktpersonen mikroskopisch offener Indexpatienten lag die Positivit\u00e4tsrate bei 11,4\u200a%, bei kulturell offenem, aber mikroskopisch negativem Indexpatient bei 14,3\u200a%. Au\u00dferdem konnte gezeigt werden, dass das m\u00e4nnliche Geschlecht (OR\u200a=\u200a1,95), Alter \u2265\u200a50 Jahre (OR\u200a=\u200a1,8) und die Exposition im Haushalt (OR\u200a=\u200a2,37) das LTBI-Infektionsrisiko erh\u00f6hten.<\/jats:p><jats:p>\n          Schlussfolgerung\u2002Unter Anwendung der DZK-Kriterien lag die Positivit\u00e4tsrate der IGRA-Testung und die Diagnosestellung LTBI unter Kontaktpersonen in der vorliegenden Untersuchung mit 12,5\u200a% niedriger als in anderen \u00e4hnlichen Studien. Die in der Kohorte identifizierten Faktoren f\u00fcr ein erh\u00f6htes Risiko einer LTBI best\u00e4tigen bekannte Konstellationen. <\/jats:p><jats:p>Die signifikant h\u00f6here Positivit\u00e4tsrate unter Kontaktpersonen mikroskopisch negativer, aber kulturell positiver Indexpatienten (p\u200a=\u200a0,033) unterstreicht die Notwendigkeit, auch in dieser Gruppe eine ausf\u00fchrliche Kontaktuntersuchung durchzuf\u00fchren. <\/jats:p>","DOI":"10.1055\/a-1479-0168","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T23:38:50Z","timestamp":1620689930000},"page":"567-576","source":"Crossref","is-referenced-by-count":2,"title":["Latente Tuberkulose unter Kontaktpersonen inzidenter Tuberkulosepatienten: H\u00e4ufigkeit und Risikofaktoren in K\u00f6ln 2012\u20132016"],"prefix":"10.1055","volume":"75","author":[{"given":"L. V.","family":"Dwenger","sequence":"additional","affiliation":[{"name":"Gesundheitsamt der Stadt K\u00f6ln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle"},{"name":"Institut f\u00fcr Arbeits-, Sozial- und Umweltmedizin, Universit\u00e4tsklinik, RWTH Aachen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Funke","sequence":"additional","affiliation":[{"name":"Gesundheitsamt der Stadt K\u00f6ln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Stephany","sequence":"additional","affiliation":[{"name":"Gesundheitsamt der Stadt K\u00f6ln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Suarez","sequence":"additional","affiliation":[{"name":"Medizinische Klinik 1, Infektionsambulanz, Universit\u00e4tsklinikum K\u00f6ln"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. A.","family":"Wiesm\u00fcller","sequence":"additional","affiliation":[{"name":"Gesundheitsamt der Stadt K\u00f6ln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle"},{"name":"Institut f\u00fcr Arbeits-, Sozial- und Umweltmedizin, Universit\u00e4tsklinik, RWTH Aachen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Neuhann","sequence":"additional","affiliation":[{"name":"Gesundheitsamt der Stadt K\u00f6ln, Abteilung Infektions- und Umwelthygiene, Tuberkulose-Beratungsstelle"},{"name":"Heidelberger Institut f\u00fcr Global Health, Universit\u00e4tsklinikum Heidelberg"},{"name":"School of Medicine and Clinical Sciences, Levy Mwanawasa Medical University, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,5,10]]},"reference":[{"key":"ref1","volume-title":"Global tuberculosis report 2019","author":"World Health Organization","year":"2019"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.25646\/6195","article-title":"Bericht zur Epidemiologie der Tuberkulose in Deutschland f\u00fcr 2018","author":"B Brodhun","year":"2019"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.25646\/6947","article-title":"Bericht zur Epidemiologie der Tuberkulose in Deutschland f\u00fcr 2019","author":"B Brodhun","year":"2020","journal-title":"Robert Koch-Institut"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1007\/s15006-018-0003-5","article-title":"Die Tuberkulose \u2013 ein Problem in Deutschland?","volume":"160","author":"B H\u00e4cker","year":"2018","journal-title":"MMW Fortschr Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e50","DOI":"10.1055\/s-0030-1256509","article-title":"Neue Empfehlungen f\u00fcr die Umgebungsuntersuchungen bei Tuberkulose","volume":"65","author":"R Diel","year":"2011","journal-title":"Pneumologie"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1164\/arrd.1969.99.1.109","article-title":"Cough frequency and infectivity in patients with pulmonary tuberculosis","volume":"99","author":"R G Loudon","year":"1969","journal-title":"Am Rev Respir Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1183\/09031936.00070812","article-title":"Contact investigation for tuberculosis: A systematic review and meta-analysis","volume":"41","author":"G J Fox","year":"2013","journal-title":"Eur Respir J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1055\/s-0043-105954","article-title":"S2k-Leitlinie. 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