{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T03:32:23Z","timestamp":1764732743217,"version":"3.37.3"},"reference-count":22,"publisher":"European Respiratory Society (ERS)","issue":"2","content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2018,2,16]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:p>Data from a prospective molecular-epidemiological study (1997\u20132015) of patients with culture-confirmed tuberculosis in Hamburg, Germany, were evaluated to assess the occupational risk of<jats:italic>Mycobacterium tuberculosis<\/jats:italic>complex transmission in a low-incidence setting.<\/jats:p><jats:p>Isolates of<jats:italic>M. tuberculosis<\/jats:italic>complex were genotyped using IS6110 restriction fragment length polymorphism analysis. Results of structured questionnaires, geographical mapping and additional patient interviews were used for confirming epidemiological links.<\/jats:p><jats:p>Out of the 2393 cases, 918 (38.4%) were classified into 224 clusters comprising 2\u201370 patients per cluster. Among the 918 cluster members, epidemiological links could be confirmed in 340 (37.0%) patients. In total, 55 (2.3%) patients were healthcare workers; 26 healthcare workers remained unclustered, but 29 healthcare workers belonged to cluster groups. Conventional contact tracing performed before genotyping to identify sources of the reported index cases detected only 73 (3.1%) patients.<\/jats:p><jats:p>Logistic regression analysis confirmed work in the healthcare sector as strongest predictor for clustering of patients with verified epidemiological links (odds ratio (OR) 3.1, 95% CI 1.6\u20135.9), followed by alcoholism (OR 2.3, 95% CI 1.7\u20133.2) and sputum smear positivity (OR 1.8, 95% CI 1.4\u20132.3). Immigrants were more likely to be cluster nonmembers (OR 0.3, 95% CI 0.3\u20130.5). Recent transmission in Hamburg within the 19-year study period was found to be strongly associated with working in a healthcare facility. Although clusters also include many \u201cimported\u201d strains from abroad or regional highly prevalent<jats:italic>M. tuberculosis<\/jats:italic>strains with no evident epidemiological connection, routine molecular-epidemiological survey is indispensable to optimising and controlling the effectiveness of TB control strategies in German healthcare settings.<\/jats:p>","DOI":"10.1183\/23120541.00161-2017","type":"journal-article","created":{"date-parts":[[2018,4,9]],"date-time":"2018-04-09T07:50:13Z","timestamp":1523260213000},"page":"00161-2017","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Risk of tuberculosis transmission among healthcare workers"],"prefix":"10.1183","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8304-7709","authenticated-orcid":false,"given":"Roland","family":"Diel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Niemann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Nienhaus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2018,4,9]]},"reference":[{"key":"2024101707084790000_4.2.00161-2017.1","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1055\/s-2000-7025","article-title":"Die Tuberkulosesituation in Deutschland 1998. 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