Observational studyAnnals of the American Thoracic Society2015
Exogenous Reinfection as a Cause of Late Recurrent Tuberculosis in the United States.
Observational study in Annals of the American Thoracic Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Infectious Diseases Among People Experiencing Homelessness: A Systematic Review of the Literature in the United States and Canada, 2003-2022.Public health reports (Washington, D.C. : 1974)Pooled it
- Characterizing the Etiology of Recurrent Tuberculosis Using Whole Genome Sequencing: Alaska, 2008-2020.The Journal of infectious diseases · 2025Article
- Recurrent tuberculosis in the Netherlands - a 24-year follow-up study, 1993 to 2016.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2022Article
- High Rates of Recurrent Tuberculosis Disease: A Population-level Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Relapse or Re-Infection, the Situation of Recurrent Tuberculosis in Eastern China.Frontiers in cellular and infection microbiology · 2021Article
- Distinguishing Relapse From Reinfection With Whole-Genome Sequencing in Recurrent Pulmonary Tuberculosis: A Retrospective Cohort Study in Beijing, China.Frontiers in microbiology · 2021Article
- Tuberculosis recurrences and predictive factors in a vulnerable population in Catalonia.PloS one · 2020Article
- Classifying recurrent Mycobacterium tuberculosis cases in Georgia using MIRU-VNTR typing.PloS one · 2019Article
- Tuberculosis: mother of thoracic surgery then and now, past and prospectives: a review.Journal of thoracic disease · 2018Review
- Recurrent tuberculosis in Finland 1995-2013: a clinical and epidemiological cohort study.BMC infectious diseases · 2017Article
- Evaluating 17 years of latent tuberculosis infection screening in north-west England: a retrospective cohort study of reactivation.The European respiratory journal · 2017Article
- Recurrent tuberculosis in an urban area in China: Relapse or exogenous reinfection?Tuberculosis (Edinburgh, Scotland) · 2017Article
- Antigenic Variation and Immune Escape in the MTBC.Advances in experimental medicine and biology · 2017Review
- Reply: Missing Stowaways and Lack of Expected Concurrent Infections.Annals of the American Thoracic Society · 2015Article
- Infection of multipleInternational journal of mycobacteriologyArticle
- Tuberculosis treatment.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e TisilogiaReview
- Initiation of Post-Primary Tuberculosis of the Lungs: Exploring the Secret Role of Bone Marrow Derived Stem Cells.Frontiers in immunologyReview
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
Abstract
rationaleThe etiology of recurrent tuberculosis is typically presumed to be reactivation of residual Mycobacterium tuberculosis infection, but reinfection may account for a greater proportion of recurrent tuberculosis than previously recognized.
objectiveTo use M. tuberculosis genotyping to characterize the etiology of recurrent tuberculosis occurring 12 months or more after treatment completion.
methodsThe study population for this national population-based cohort was drawn from the estimated 3,039 persons reported to the National Tuberculosis Surveillance System with two episodes of tuberculosis in the United States during 1993-2011, 194 of whom had genotyping results from both the initial and subsequent episode. We analyzed the proportion of recurrent tuberculosis attributable to and risk factors associated with reinfection. MEASUREMENTS AND MAIN
resultsAmong 136 recurrences meeting inclusion criteria, genotypes between episodes were the same for 116 (85%) recurrences during 1996-2011; the 20 (15%) with differing genotypes were categorized as reinfections. Using exact logistic regression, factors associated with reinfection included Mexican birth with both TB episodes diagnosed in the United States within 12 years of immigration (adjusted odds ratio, 10.7; 95% confidence interval, 1.7-86.3) and exclusive use of directly observed therapy for treatment of the first episode (adjusted odds ratio, 4.5; 95% confidence interval, 1.0-29.2).
conclusionsReinfection was the cause of 15% of late recurrent tuberculosis cases in this U.S. cohort. The proportion caused by reinfection increased to 60% in certain subpopulations, such as recent immigrants from Mexico, suggesting that, despite successful treatment for tuberculosis during their first episode, these individuals remain in a social environment where they are reexposed to M. tuberculosis. Public health interventions to prevent novel reinfection might require a broader focus in these communities.
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