{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T08:58:07Z","timestamp":1794560287984,"version":"4.9.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2005,4,14]],"date-time":"2005-04-14T00:00:00Z","timestamp":1113436800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Respir Res"],"published-print":{"date-parts":[[2005,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>To investigate the occupational risk of tuberculosis (TB) infection in a low-incidence setting, data from a prospective study of patients with culture-confirmed TB conducted in Hamburg, Germany, from 1997 to 2002 were evaluated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>\n              <jats:italic>M. tuberculosis<\/jats:italic> isolates were genotyped by IS<jats:italic>6110<\/jats:italic> RFLP analysis. Results of contact tracing and additional patient interviews were used for further epidemiological analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Out of 848 cases included in the cluster analysis, 286 (33.7%) were classified into 76 clusters comprising 2 to 39 patients. In total, two patients in the non-cluster and eight patients in the cluster group were health-care workers. Logistic regression analysis confirmed work in the health-care sector as the strongest predictor for clustering (OR 17.9). However, only two of the eight transmission links among the eight clusters involving health-care workers had been detected previously. Overall, conventional contact tracing performed before genotyping had identified only 26 (25.2%) of the 103 contact persons with the disease among the clustered cases whose transmission links were epidemiologically verified.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Recent transmission was found to be strongly associated with health-care work in a setting with low incidence of TB. Conventional contact tracing alone was shown to be insufficient to discover recent transmission chains. The data presented also indicate the need for establishing improved TB control strategies in health-care settings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1465-9921-6-35","type":"journal-article","created":{"date-parts":[[2005,4,15]],"date-time":"2005-04-15T06:14:23Z","timestamp":1113545663000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Occupational risk of tuberculosis transmission in a low incidence area"],"prefix":"10.1186","volume":"6","author":[{"given":"Roland","family":"Diel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Seidler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Nienhaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"R\u00fcsch-Gerdes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Niemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2005,4,14]]},"reference":[{"key":"273_CR1_273","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1086\/517405","volume":"177","author":"WZ Bradford","year":"1988","unstructured":"Bradford WZ, Koehler J, El-Hajj H, Hopewell PC, Reingold AL, Agasino CB, Cave MD, Rane S, Yang Z, Crane CM, Small PM: Dissemination of\nMycobacterium tuberculosis\nacross the San Francisco Bay Area.\nJ Infect Dis 1988, 177:1104\u20131107.","journal-title":"J Infect Dis"},{"key":"273_CR2_273","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1128\/JCM.36.2.486-492.1998","volume":"36","author":"MC Gutierrez","year":"1998","unstructured":"Gutierrez MC, Vincent V, Aubert D, Bizet J, Gaillot O, Lebrun L, Le Pendeven C, Le Pennec MP, Mathieu D, Offredo C, Pangon B, Pierre-Audigier C: Molecular fingerprinting of\nMycobacterium tuberculosis\nand risk factors for tuberculosis transmission in Paris, France, and surrounding area.\nJ Clin Microbiol 1998, 36:486\u2013492.","journal-title":"J Clin Microbiol"},{"key":"273_CR3_273","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1086\/314930","volume":"3","author":"D van Soolingen","year":"1999","unstructured":"van Soolingen D, Borgdorff MW, de Haas PE, Sebek MM, Veen J, Dessens M, Kremer K, van Embden JD: Molecular epidemiology of tuberculosis in the Netherlands: a nationwide study from 1993 through 1997.\nJ Infect Dis 1999, 3:726\u2013736.","journal-title":"J Infect Dis"},{"key":"273_CR4_273","doi-asserted-by":"publisher","first-page":"1710","DOI":"10.1056\/NEJM199406163302403","volume":"330","author":"D Alland","year":"1994","unstructured":"Alland D, Kalkut GE, Moss AR, McAdam RA, Hahn JA, Bosworth W, Drucker E, Bloom BR: Transmission of tuberculosis in New York City. An analysis by DNA fingerprinting and conventional epidemiological methods.\nN Engl J Med 1994, 330:1710\u20131716.","journal-title":"N Engl J Med"},{"key":"273_CR5_273","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.1056\/NEJM199406163302402","volume":"330","author":"PM Small","year":"1994","unstructured":"Small PM, Hopewell PC, Singh SP, Paz A, Parsonnet J, Ruston DC, Schecter GF, Daley CL, Schoolnik GK: The epidemiology of tuberculosis in San Francisco. A population-based study using conventional and molecular methods.\nN Engl J Med 1994, 330:1703\u20131709.","journal-title":"N Engl J Med"},{"key":"273_CR6_273","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1128\/JCM.40.2.532-539.2002","volume":"40","author":"R Diel","year":"2002","unstructured":"Diel R, Schneider S, Meywald-Walter K, Ruf CM, R\u00fcsch-Gerdes S, Niemann S: Epidemiology of tuberculosis in Hamburg, Germany: A long-term population-based analysis applying classical and molecular epidemiological techniques.\nJ Clin Microbiol 2002, 40:532\u2013539.","journal-title":"J Clin Microbiol"},{"key":"273_CR7_273","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1086\/516072","volume":"25","author":"H van Deutekom","year":"1997","unstructured":"van Deutekom H, Gerritsen JJ, van Soolingen D, van Ameijden EJ, van Embden JD, Coutinho RA: A molecular epidemiological approach to studying the transmission of tuberculosis in Amsterdam.\nClin Infect Dis 1997, 25:1071\u20131077.","journal-title":"Clin Infect Dis"},{"key":"273_CR8_273","first-page":"390","volume":"2","author":"N Lemaitre","year":"1998","unstructured":"Lemaitre N, Sougakoff W, Truffot-Pernot C, Cambau E, Derenne JP, Bricaire F, Grosset J, Jarlier V: Use of DNA fingerprinting for primary surveillance of nosocomial tuberculosis in a large urban hospital: detection of outbreaks in homeless people and migrant workers.\nInt J Tuberc Lung Dis 1998, 2:390\u2013396.","journal-title":"Int J Tuberc Lung Dis"},{"key":"273_CR9_273","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1093\/clinids\/21.5.1098","volume":"21","author":"KA Sepkowitz","year":"1995","unstructured":"Sepkowitz KA, Friedman CR, Hafner A, Kwok D, Manoach S, Floris M, Martinez D, Sathianathan K, Brown E, Berger JJ, Segal-Mauer S, Kreiswirth B, Stoeckle MY, Riley LW: Tuberculosis among urban health care workers: a study using restriction fragment length polymorphism typing.\nClin Infect Dis 1995, 21:1098\u20131101.","journal-title":"Clin Infect Dis"},{"key":"273_CR10_273","first-page":"423","volume":"50","author":"Robert Koch-Institut","year":"2002","unstructured":"Robert Koch-Institut: Tuberkulose in Deutschland 2001.\nEpidemiol Bull 2002, 50:423\u2013425.","journal-title":"Epidemiol Bull"},{"key":"273_CR11_273","volume-title":"Meldepflichtige Infektionskrankheiten in Hamburg","author":"Hygiene Institut Hamburg","year":"2001","unstructured":"Hygiene Institut Hamburg: Meldepflichtige Infektionskrankheiten in Hamburg. Hamburg: Hygiene Institut Hamburg; 2001."},{"key":"273_CR12_273","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1183\/09031936.98.12020505","volume":"12","author":"J Veen","year":"1988","unstructured":"Veen J, Raviglione M, Rieder HL, Migliori GB, Graf P, Grzemska M, Zalesky R: Standardized tuberculosis treatment outcome monitoring in Europe.\nEur Respir J 1988, 12:505\u2013510.","journal-title":"Eur Respir J"},{"issue":"No. RR-13","key":"273_CR13_273","first-page":"1","volume":"43","author":"Centers for Disease Control and Prevention","year":"1994","unstructured":"Centers for Disease Control and Prevention: Guidelines for preventing the transmission of\nMycobacterium tuberculosis\nin health-care facilities.\nMMWR 1994,43(No. RR-13):1\u2013141.","journal-title":"MMWR"},{"key":"273_CR14_273","volume-title":"The ICD-10 classification of mental and behavioral disorders","author":"World Health Organization","year":"1992","unstructured":"World Health Organization: The ICD-10 classification of mental and behavioral disorders. Geneva: World Health Organization; 1992."},{"key":"273_CR15_273","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1128\/jcm.31.2.406-409.1993","volume":"31","author":"JD van Embden","year":"1993","unstructured":"van Embden JD, Cave MD, Crawford JT, Dale JW, Eisenach KD, Gicquel B, Hermans P, Martin C, McAdam R, Shinnick TM, Small P: Strain identification of\nMycobacterium tuberculosis\nby DNA fingerprinting: recommendations for a standardized methodology.\nJ Clin Microbiol 1993, 31:406\u2013409.","journal-title":"J Clin Microbiol"},{"key":"273_CR16_273","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1128\/JCM.37.2.409-412.1999","volume":"37","author":"S Niemann","year":"1999","unstructured":"Niemann S, R\u00fcsch-Gerdes S, Richter E, Thielen H, Heykes-Uden H, Diel R: Stability of\nMycobacterium tuberculosis\nIS\n6110\nrestriction fragment length polymorphism patterns and spoligotypes determined by analyzing serial isolates from patients with drug-resistant tuberculosis.\nJ Clin Microbiol 1999, 37:409\u2013412.","journal-title":"J Clin Microbiol"},{"key":"273_CR17_273","doi-asserted-by":"crossref","first-page":"3015","DOI":"10.1128\/jcm.35.12.3015-3020.1997","volume":"35","author":"S Niemann","year":"1997","unstructured":"Niemann S, R\u00fcsch-Gerdes S, Richter E: IS\n6110\nfingerprinting of drug-resistant\nMycobacterium tuberculosis\nstrains isolated in Germany during 1995.\nJ Clin Microbiol 1997, 35:3015\u20133020.","journal-title":"J Clin Microbiol"},{"key":"273_CR18_273","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1093\/infdis\/171.6.1504","volume":"171","author":"PWM Hermans","year":"1995","unstructured":"Hermans PWM, Messadi F, Guebrexabher H, van Soolingen D, de Haas PEW, Heersma H, de Neeling H, Ayoub A, Portaels F, Frommel D, Zribi M, van Embden JDA: Analysis of the population structure of\nMycobacterium tuberculosis\nin Ethiopia, Tunisia, and the Netherlands: usefulness of DNA typing for global tuberculosis epidemiology.\nJ Infect Dis 1995, 171:1504\u20131513.","journal-title":"J Infect Dis"},{"key":"273_CR19_273","first-page":"395","volume":"101","author":"HF Heersma","year":"1998","unstructured":"Heersma HF, Kremer K, van Embden JD: Computer analysis of IS\n6110\nRFLP patterns of\nMycobacterium tuberculosis\n.\nMethods Mol Biol 1998, 101:395\u2013422.","journal-title":"Methods Mol Biol"},{"issue":"RR-8","key":"273_CR20_273","first-page":"7","volume":"39","author":"Centers for Disease Control and Prevention","year":"1990","unstructured":"Centers for Disease Control and Prevention: Prevention and control of tuberculosis in facilities providing long-term care for the elderly: recommendations of the Advisory committee for Elimination of Tuberculosis.\nMMWR 1990,39(RR-8):7\u201320.","journal-title":"MMWR"},{"key":"273_CR21_273","first-page":"1271","volume":"161","author":"K Schwartzman","year":"1999","unstructured":"Schwartzman K, Menzies D: Tuberculosis: 11. Nosocomial disease.\nCMAJ 1999, 161:1271\u20131277.","journal-title":"CMAJ"},{"key":"273_CR22_273","first-page":"358","volume":"82","author":"L Sultan","year":"1960","unstructured":"Sultan L, Nyka W, Mills C, O'Grady F, Wells W, Riley RL: Tuberculosis disseminators: a study of the variability of aerial infectivity of tuberculosis patients.\nAm Rev Respir Dis 1960, 82:358\u2013369.","journal-title":"Am Rev Respir Dis"},{"key":"273_CR23_273","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.3201\/eid0811.020403","volume":"8","author":"BA Ellis","year":"2002","unstructured":"Ellis BA, Crawford JT, Braden CR, McNabb SJ, Moore M, Kammerer S: Molecular epidemiology of tuberculosis in a sentinel surveillance population.\nEmerg Infec Dis 2002, 8:1197\u2013209.","journal-title":"Emerg Infec Dis"},{"key":"273_CR24_273","first-page":"1055","volume":"3","author":"JR Glynn","year":"1999","unstructured":"Glynn JR, Bauer J, de Boer AS, Borgdorff MW, Fine PE, Godfrey-Faussett P, Vynnycky E: Interpreting DNA fingerprint clusters of\nMycobacterium tuberculosis\n. European Concerted Action on Molecular Epidemiology and Control of Tuberculosis.\nInt J Tuberc Lung Dis 1999, 3:1055\u20131060.","journal-title":"Int J Tuberc Lung Dis"},{"key":"273_CR25_273","first-page":"657","volume":"58","author":"Deutsches Zentralkomitee zur Bek\u00e4mpfung der Tuberkulose","year":"1996","unstructured":"Deutsches Zentralkomitee zur Bek\u00e4mpfung der Tuberkulose: Richtlinien f\u00fcr die Umgebungsuntersuchungen bei Tuberkulose.\nGesund-Wes 1996, 58:657\u2013665.","journal-title":"Gesund-Wes"},{"key":"273_CR26_273","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/0962-8479(92)90058-R","volume":"73","author":"J Veen","year":"1992","unstructured":"Veen J: Microepidemics of tuberculosis: the stone-in-the-pond principle.\nTuberc Lung Dis 1992, 73:73\u201376.","journal-title":"Tuberc Lung Dis"},{"key":"273_CR27_273","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1086\/314991","volume":"180","author":"A Yaganehdoost","year":"1999","unstructured":"Yaganehdoost A, Graviss EA, Ross MW, Adams GJ, Ramaswamy S, Wanger A, Frothingham R, Soini H, Musser JM: Complex transmission dynamics of clonally related virulent\nMycobacteriom tuberculosis\nassociated with barhopping by predominantly human immunodeficiency virus-positive gay men.\nJ Infect Dis 1999, 180:1245\u20131251.","journal-title":"J Infect Dis"},{"key":"273_CR28_273","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1007\/s00103-001-0363-2","volume":"45","author":"Robert Koch Institut","year":"2002","unstructured":"Robert Koch Institut: Empfehlungen der Kommission f\u00fcr Krankenhaushygiene. Ausbruchsmanagment und strukturiertes Vorgehen bei geh\u00e4uftem Auftreten nosokomialer Infektionen.\nBundesgesundheitsbl-Gesundheitsforsch-Gesund-heitsschutz 2002, 45:180\u2013186.","journal-title":"Bundesgesundheitsbl-Gesundheitsforsch-Gesund-heitsschutz"}],"container-title":["Respiratory Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1465-9921-6-35.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1465-9921-6-35\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1465-9921-6-35","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1465-9921-6-35.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T09:49:43Z","timestamp":1630489783000},"score":1,"resource":{"primary":{"URL":"https:\/\/respiratory-research.biomedcentral.com\/articles\/10.1186\/1465-9921-6-35"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,4,14]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,12]]}},"alternative-id":["273"],"URL":"https:\/\/doi.org\/10.1186\/1465-9921-6-35","relation":{},"ISSN":["1465-993X"],"issn-type":[{"value":"1465-993X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,4,14]]},"assertion":[{"value":"10 January 2005","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2005","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2005","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"35"}}