Unknown Source Of Infection Research Articles

Spectrum of Hepatits B Infection Among Patients Attending Liver Unit in Nepalgunj Medical College – Kohalpur

Introduction: Hepatitis B infection is a global problem. Hepatitis B virus (HBV) infection related liver disease is also not an uncommon problem in our country too. Reports regarding pattern of chronic HBV infection are also lacking. The aim of the present study was to determine the spectrum of chronic HBV infection among patients attending the liver clinic in a tertiary care center.
 Method: A hospital based descriptive cross-sectional study was carried out in Liver unit of Nepalgunj Medical College, Kohalpur, from April 2018 to November 2018. All patients with HBsAg positive were further tested for HBeAg, HBeAb, HBV DNA quantitative and liver function test. Ultrasound examination was advised for any evidence of chronic liver disease. Staging was done according to viral serology, liver biochemistry and ultrasonography of liver
 Results: Total patients enrolled were 119. Majority of patents were in between 30-60 years (51.3%) with male predominance 59.7%. Most of patients were in the stage of HBeAg negative chronic infection 66.4% with normal transaminase and HBV DNA <2000 IU/ML. Majority of patients having unknown source of infection 90.8%. Incidental detection (67.2%) was common mode of detection.
 Conclusions: Majority of patients were in HBeAg negative chronic hepatitis B infection phase with normal transaminase and low HBV DNA not requiring treatment.

Effectiveness of total hip arthroplasty for hip infection sequelae

To evaluate hip function and reinfection of the patients with hip infection sequelae after total hip arthroplasty (THA) treatment. A clinical data of 31 patients (31 hips) with hip infection sequelae, who were treated with THA between June 2010 and May 2017, was retrospectively analyzed. There were 18 males and 13 females, with an average age of 46.1 years (range, 20-71 years). There were pyogenic infection in 17 cases, tuberculous infection in 9 cases, and unknown source of infection in 5 cases. The average time from infection to cure was 13.9 months (range, 6-25 months). The average time from cure to operation was 23.4 years (range, 6-58 years) for patients with confirmed source of infection. According to Kim classification, 12 cases were rated as typeⅠ, 9 as typeⅡ, and 10 as type Ⅲ. There were 21 cases of osteoarthritis after dysplasia, 7 cases of pathologic dislocation, and 3 cases of hip ankylosis. After operation, the infection was assessed by physical signs and laboratory tests; X-ray film of the hip was taken to assess the skeletal structure of the hip and infectious lesion; the length of the lower limb was measured, and the function of the hip joint was evaluated by Harris score. All patients were followed up 10-63 months (mean, 34 months). The result of bacterial culture was negative. The incisions healed by first intention. The sciatic nerve stimulation occurred in 1 case and posterior dislocation of the joint occurred in 1 case after operation. There was no recurrence of infection and no aseptic loosening of the prosthesis. According to Harris score, the function of the hip was rated as excellent in 8 cases, good in 19 cases, and fair in 4 cases at last follow-up; and the excellent and good rate of hip joint function was 87%. X-ray films showed no patchy bone density reduction, spot hardening, or light areas. The length of affected limb was not fully equal with the unaffected limb in 5 cases, and the difference between two sides ranged from 0.4 to 1.3 cm (mean, 0.6 cm). At last follow-up, all patients had no obvious claudication or sensation of unequal length. THA can obtain satisfactory hip function and has low risk of infection recurrence for the patients with hip infection sequelae, who were assessed as the hip infection in a dormant state.

Risk Factors Associated With Outbreaks of Infectious Salmon Anemia (ISA) With Unknown Source of Infection in Norway.

The occurrence of infectious salmon anemia (ISA) outbreaks in marine farmed Atlantic salmon constitutes a recurring challenge in Norway. Here, we aim to identify risk factors associated with ISA outbreaks with an unknown source of infection (referred to as primary ISA outbreaks). Primary ISA outbreaks are here defined by an earlier published transmission model. We explored a wide range of possible risk factors with logistic regression analysis, trying to explain occurrence of primary ISA with available data from all Norwegian farm sites from 2004 to June 2017. Explanatory variables included site latitude and a range of production and disease data. The mean annual risk of having a primary outbreak of ISA in Norway was 0.7% during this study period. We identified the occurrence of infectious pancreatic necrosis (IPN), having a stocking period longer than 2 months, having the site located at high latitude and high fish density (biomass per cage volume) in the first six months after transfer to sea site as significant risk factors (p < 0.05). We have identified factors related to management routines, other disease problems, and latitude that may help to understand the hitherto unidentified drivers behind the emergence of primary ISA outbreaks. Based on our findings, we also provide management advice that may reduce the incidence of primary ISA outbreaks.

Whole Genome Sequencing of Mycobacterium bovis Isolated From Livestock in the United States, 1989-2018.

The United States official bovine tuberculosis (bTB) eradication program has utilized genotyping for Mycobacterium bovis isolates since 2000 and whole genome sequencing was implemented in 2013. The program has been highly successful, yet as bTB prevalence has reached historic lows, a small number of new bTB-affected cattle herds occur annually. Therefore, understanding the epidemiology of bTB transmission is critically important, in order to target limited resources for surveillance and achieve eradication. This evaluation described the diversity and epidemiology of M. bovis isolates identified in the USA livestock. Isolates from animals within the bTB endemic area of Michigan were excluded. Broad diversity was found among 1,248 isolates, collected from affected cattle and farmed cervids herds and fed cattle during 1989–2018. Nearly 70% of isolates from 109 herds/cases during 1999–2018 were European clonal complex 1 and 30% were European clonal complex 2. The sources of infection based on the herd investigation were known for 41% of herds/cases and 59% were not epidemiologically linked to another USA origin herd. Whole genome sequencing results were consistent with the investigation findings and previously unrecognized links between herds and cases were disclosed. For herds/cases with an unknown source of infection, WGS results suggested several possible sources, including undocumented cattle movement, imported cattle and humans. The use of WGS in new cases has reduced the time and costs associated with epidemiological investigations. Within herd SNP diversity was evaluated by examining 18 herds with 10 or more isolates sequenced. Forty percent of isolates had not diverged or accumulated any SNPs, and 86% of the isolates had accumulated 3 or fewer SNPs. The results of WGS does not support a bTB reservoir in USA cattle. The bTB eradication program appears to be highly effective as the majority of herds/cases in the USA are unique strains with limited herd to herd transmission.

Ludwig's angina: Pediatric case report and literature review

Ludwig's angina (LA) is a serious, rapidly progressive cellulitis of the floor of the mouth which involves the submandibular, submaxillary, and sublingual spaces of the face; it is life-threatening if not recognized early and complications such as septicemia and asphyxia caused by expanding edema of soft tissues of the neck may occur. A literature review identified 35 pediatric cases of LA with a 14% mortality rate. It occurs predominantly in immunocompetent children with an odontogenic source of infection in a third and unknown source of infection in a third of cases. Many departments may have limited experience of the disease because of its rare occurrence. Hence, it is important to recognize LA in the earlier stages of the disease. We here present a case of huge LA in a 6-month-old male child with a very short history.

Late-onset sepsis due to urinary tract infection in very preterm neonates is not uncommon

Urinary tract infection (UTI) is a common cause of sepsis in infants. Premature infants hospitalized at a neonatal intensive care unit often have risk factors for infection. In this group, the risk of UTI is not clearly known, and guidelines for urine analysis are not unanimous. We aimed to identify the risk of UTI in premature infants with central lines, suspected of late-onset sepsis. We analyzed all 1402 infants admitted to our hospital between 2006 and 2014 with a gestational age less than 32 weeks. Six hundred sixty-two episodes of sepsis evaluations were found with an unknown source of infection based on clinical symptoms. In half of this group, urine analysis was performed identifying UTI in 11.3% (24/212). In 13 of these infants (54%) with a UTI, infection was due to Candida albicans. In at least four episodes, the diagnosis and treatment would have been delayed if urine analysis had not been performed.Conclusion: Based on these findings, we conclude that in premature infants with central lines, urine analysis should be performed routinely when signs of infection occur beyond 72 h after birth. Urine collection should not be delayed and cultures should preferably be performed before the start of the antibiotic treatment.What is known:• In preterm infants, the presence of other risk factors for infection might make clinicians reluctant to obtain urine cultures during sepsis evaluation.• An internal survey demonstrated that there is no consensus within the NICUs in The Netherlands regarding urine analysis as part of LOS work-up.What is new:• The risk of UTI in the NICU population (11.3%) is comparable to term infants; therefore, urine analysis should be performed routinely when LOS is suspected.• Candida albicans was the most frequently (54%) detected pathogen causing UTI in this population.

Diagnostic delays in 537 symptomatic cases of Middle East respiratory syndrome coronavirus infection in Saudi Arabia

BackgroundAlthough the literature indicates that patient delays in seeking medical support for Middle East respiratory syndrome coronavirus (MERS-CoV) infections are associated with poor clinical outcomes, delays in the diagnosis itself remain poorly understood in these patients. This study aimed to determine the median time interval from symptom onset to a confirmed diagnosis and to identify the potential predictors of this interval in Saudi Arabian MERS patients. MethodsThis was a retrospective study of patients with confirmed MERS who were publicly reported by the World Health Organization (WHO). ResultsFive hundred and thirty-seven symptomatic cases of MERS-CoV infection were included. The median time interval between symptom onset and confirmation of the MERS diagnosis was 4 days (interquartile range 2–7 days), ranging from 0 to 36 days. According to the negative binomial model, the unadjusted rate ratio (RR) of delays in the diagnosis was significantly higher in older patients (>65 years) (RR 1.42), non-healthcare workers (RR 1.74), patients with severe illness (RR 1.22), those with an unknown source of infection (RR 1.84), and those who had been in close contact with camels (RR 1.74). After accounting for confounders, the adjusted rate ratio (aRR) of delays in the diagnosis was independently associated with unknown source of infection (aRR 1.68) and close contact with camels (aRR 1.58). ConclusionsThe time interval from symptom onset to diagnosis was greater in older patients, non-healthcare workers, patients with severe illness, patients with an unknown source of infection, and patients who had been in close contact with camels. The findings warrant educational interventions to raise general public awareness of the importance of early symptom notification.

Infectious Diseases Team for the Early Management of Severe Sepsis and Septic Shock in the Emergency Department.

The impact on patient survival of an infectious disease (ID) team dedicated to the early management of severe sepsis/septic shock (SS/SS) in Emergency Department (ED) has yet to be assessed. A quasiexperimental pre-post study was performed at the general ED of our hospital. During the pre phase (June 2013-July 2014), all consecutive adult patients with SS/SS were managed according to the standard of care, data were prospectively collected. During the post phase (August 2014-October 2015), patients were managed in collaboration with a dedicated ID team performing a bedside patient evaluation within 1 hour of ED arrival. Overall, 382 patients were included, 195 in the pre phase and 187 in the post phase. Median age was 82 years (interquartile range, 70-88). The most common infection sources were lung (43%) and urinary tract (17%); in 22% of cases, infection source remained unknown. During the post phase, overall compliance with the Surviving Sepsis Campaign (SSC) bundle and appropriateness of initial antibiotic therapy improved from 4.6% to 32% (P < .001) and from 30% to 79% (P < .001), respectively. Multivariate analysis showed that predictors of all-cause 14-day mortality were quick sepsis-related organ failure assessment ≥2 (hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.15-2.45; P = .007), serum lactate ≥2 mmol/L (HR, 2.13; 95% CI, 1.39-3.25; P < .001), and unknown infection source (HR, 2.07; 95% CI, 1.42-3.02; P < .001); being attended during the post phase was a protective factor (HR, 0.64; 95% CI, 0.43-0.94; P = .026). Implementation of an ID team for the early management of SS/SS in the ED improved the adherence to SSC recommendations and patient survival.

Asociación entre la endocarditis infecciosa por Enterococcus faecalis y la neoplasia de colon: resultados preliminares a partir de una cohorte de 154 pacientes

Introduction and objectivesThe association between Streptococcus bovis group infective endocarditis and colorectal neoplasm (CRN) is well-known. However, no studies have assessed the association between Enterococcus faecalis infective endocarditis (EFIE) and CRN. We aimed to determine whether the prevalence of CRN is higher in patients with EFIE and an unclear source of infection than in patients with EFIE and a known source of infection or in the general population. MethodsRetrospective analysis of a cohort of 154 patients with definite EFIE (109 with an unclear source of infection and 45 with an identified source) from 2 Spanish teaching hospitals to determine the prevalence of CRN and other colorectal diseases. ResultsIn the group with an unknown source of infection, 61 patients (56%) underwent colonoscopy; of these, 31 (50.8%) had CRN. Nonadvanced colorectal adenoma was detected in 22 patients (36%), advanced adenoma in 5 (8.2%), and colorectal carcinoma (CRC) in 4 (6.6%). Among patients who survived the EFIE episode with ≥ 2 years of follow-up, 1 case of CRC was subsequently diagnosed. Only 6 patients (13.3%) with an identified focus of infection underwent colonoscopy; 1 of these patients (16.7%) was diagnosed with CRN. The prevalence of adenomas was slightly higher than that of the Spanish population in the same age range, whereas that of CRC was 17-fold higher. ConclusionsCRN was found in more than half of patients with EFIE and an unclear focus of infection who underwent colonoscopy. Colonoscopy should be recommended in patients with EFIE and an unclear source of infection.Full English text available from:www.revespcardiol.org/en

Abstract No. 566 - Clinical implication and safety of inferior vena cava (IVC) filter placement in patients with bacteremia or systemic inflammatory response syndrome (SIRS) with unknown source of infection

Abstract No. 566 - Clinical implication and safety of inferior vena cava (IVC) filter placement in patients with bacteremia or systemic inflammatory response syndrome (SIRS) with unknown source of infection

Relationship Between Enterococcus faecalis Infective Endocarditis and Colorectal Neoplasm: Preliminary Results From a Cohort of 154 Patients

Introduction and objectivesThe association between Streptococcus bovis group infective endocarditis and colorectal neoplasm (CRN) is well-known. However, no studies have assessed the association between Enterococcus faecalis infective endocarditis (EFIE) and CRN. We aimed to determine whether the prevalence of CRN is higher in patients with EFIE and an unclear source of infection than in patients with EFIE and a known source of infection or in the general population. MethodsRetrospective analysis of a cohort of 154 patients with definite EFIE (109 with an unclear source of infection and 45 with an identified source) from 2 Spanish teaching hospitals to determine the prevalence of CRN and other colorectal diseases. ResultsIn the group with an unknown source of infection, 61 patients (56%) underwent colonoscopy; of these, 31 (50.8%) had CRN. Nonadvanced colorectal adenoma was detected in 22 patients (36%), advanced adenoma in 5 (8.2%), and colorectal carcinoma (CRC) in 4 (6.6%). Among patients who survived the EFIE episode with ≥ 2 years of follow-up, 1 case of CRC was subsequently diagnosed. Only 6 patients (13.3%) with an identified focus of infection underwent colonoscopy; 1 of these patients (16.7%) was diagnosed with CRN. The prevalence of adenomas was slightly higher than that of the Spanish population in the same age range, whereas that of CRC was 17-fold higher. ConclusionsCRN was found in more than half of patients with EFIE and an unclear focus of infection who underwent colonoscopy. Colonoscopy should be recommended in patients with EFIE and an unclear source of infection.

Impact of Time to Appropriate Therapy on Mortality in Patients with Vancomycin-Intermediate Staphylococcus aureus Infection.

Despite the increasing incidence of vancomycin-intermediate Staphylococcus aureus (VISA) infections, few studies have examined the impact of delay in receipt of appropriate antimicrobial therapy on outcomes in VISA patients. We examined the effects of timing of appropriate antimicrobial therapy in a cohort of patients with sterile-site methicillin-resistant S. aureus (MRSA) and VISA infections. In this single-center, retrospective cohort study, we identified all patients with MRSA or VISA sterile-site infections from June 2009 to February 2015. Clinical outcomes were compared according to MRSA/VISA classification, demographics, comorbidities, and antimicrobial treatment. Thirty-day all-cause mortality was modeled with Kaplan-Meier curves. Multivariate logistic regression analysis (MVLRA) was used to determine odds ratios for mortality. We identified 354 patients with MRSA (n = 267) or VISA (n = 87) sterile-site infection. Fifty-five patients (15.5%) were nonsurvivors. Factors associated with mortality in MVLRA included pneumonia, unknown source of infection, acute physiology and chronic health evaluation (APACHE) II score, solid-organ malignancy, and admission from skilled care facilities. Time to appropriate antimicrobial therapy was not significantly associated with outcome. Presence of a VISA infection compared to that of a non-VISA S. aureus infection did not result in excess mortality. Linezolid use was a risk for mortality in patients with APACHE II scores of ≥14. Our results suggest that empirical vancomycin use in patients with VISA infections does not result in excess mortality. Future studies should (i) include larger numbers of patients with VISA infections to confirm the findings presented here and (ii) determine the optimal antibiotic therapy for critically ill patients with MRSA and VISA infections.

Risk factors for long-term mortality of Staphylococcus aureus bacteremia.

Staphylococcus aureus bacteremia (SAB) is a fatal disease. We aimed to describe risk factors for long-term mortality with SAB. We analyzed data from a retrospectively collected database including 1,692 patients with SAB. We considered variables of infection and background conditions for the analysis of long-term survival. The Kaplan-Meier procedure was used for analysis of long-term survival. Variables significantly associated with mortality were analyzed using a Cox regression model. We included 1,692 patients in the analysis. Patients were followed for up to 22 years. Within one year, 62% of patients died and within 5 years 72% died. A total of 82% of patients aged 65 years and older died within 5 years. Independent predictors of long-term mortality were older age (Hazard ratio 1.029, 95% confidence interval 1.022-1.036), female gender (HR 1.302, 95% CI 1.118-1.517), pneumonia or primary/ unknown source of infection (HR 1.441, 95% CI 1.230-1.689), dementia (HR 1.234, 95% CI 1.004-1.516), higher Charlson score (HR 1.155, 95% CI 1.115-1.196), shock at onset (HR 1.776, 95% CI 1.430-2.207) and arrival to hospitalization from an institution (HR 1.319, 95% CI 1.095-1.563). Long-term survival of patients older than 65 years and of women with SAB is severely curtailed.

Duration of Antimicrobial Treatment for Bacteremia in Canadian Critically Ill Patients.

The optimum duration of antimicrobial treatment for patients with bacteremia is unknown. Our objectives were to determine duration of antimicrobial treatment provided to patients who have bacteremia in ICUs, to assess pathogen/patient factors related to treatment duration, and to assess the relationship between treatment duration and survival. Retrospective cohort study. Fourteen ICUs across Canada. Patients with bacteremia and were present in the ICU at the time culture reported positive. Duration of antimicrobial treatment for patients who had bacteremia in ICU. Among 1,202 ICU patients with bacteremia, the median duration of treatment was 14 days, but with wide variability (interquartile range, 9-17.5). Most patient characteristics were not associated with treatment duration. Coagulase-negative staphylococci were the only pathogens associated with shorter treatment (odds ratio, 2.82; 95% CI, 1.51-5.26). The urinary tract was the only source of infection associated with a trend toward lower likelihood of shorter treatment (odds ratio, 0.67; 95% CI, 0.42-1.08); an unknown source of infection was associated with a greater likelihood of shorter treatment (odds ratio, 2.14; 95% CI, 1.17-3.91). The association of treatment duration and survival was unstable when analyzed based on timing of death. Critically ill patients who have bacteremia typically receive long courses of antimicrobials. Most patient/pathogen characteristics are not associated with treatment duration; survivor bias precludes a valid assessment of the association between treatment duration and survival. A definitive randomized controlled trial is needed to compare shorter versus longer antimicrobial treatment in patients who have bacteremia.

Secondary Syphilis in Patients Treated at the City Institute for Skin and Venereal Diseases in Belgrade from 2010 to 2014

Abstract The aim of this study was to analyze the characteristics and clinical manifestations of secondary syphilis among patients registered at the City Institute for Skin and Venereal Diseases in Belgrade, during the period from 2010 to 2014. The study was designed as a case-note review. In the five-year period, a total of 62 patients with secondary syphilis were registered. The average patient age was 32 years. There were 45 (72.6%) HIV-negative, and 17 (27.4%) HIV-positive patients. The incidence of HIV–positive patients was significantly different from random distribution (p = 0.016). All HIV-positive patients were unmarried men. A significant percentage of HIV-positive patients were unemployed (p &lt; 0.001), reported unknown source of infection (p = 0.002) and were all homosexuall (p = 0.026). More than 25% of all patients with syphilis had a history of chancres, and it was still present at the time of examination in 11.3% of all patients. The majority of cases (87.1%) had a rash, and lymphadenopathy was found in 20% of patients. However, syphilitic alopecia was detected only in HIV-positive cases (p = 0.004). There were no statistically significant differences between HIV-positive and HIV-negative patients in regard to other clinical manifestations, such as mucous patches and condylomata lata. Being a great imitator, secondary syphilis may manifest in a myriad of diverse morphological entities and clinical manifestations. We review a range of cutaneous manifestations of secondary syphilis and skin diseases it may mimic. Clinicians must be vigilant and consider syphilis in differential diagnosis, and maintain a high index of suspicion, especially when assessing vulnerable populations, such as men who have sex with men and HIV-infected individuals.

Ludwig?s Angina: Paediatric Case Report and Literature Review

Ludwig’s Angina (LA) is an uncommon but potentially fatal cellulitis of the submandibular space, complicated by contiguous spread of infection within the respiratory tract and acute airway obstruction. A 13 month-old female developed LA following upper respiratory tract infection with Parainfluenza-3 virus. There was rapid deterioration due to acute airway obstruction and emergency endoctracheal intubation was necessary. A literature review identified thirty-five paediatric cases of LA with a 14% mortality rate. It occurs predominantly in immunocompetent children with an odontogenic source of infection in a third and unknown source of infection in a third of cases. This is the first reported case of a child with preceding respiratory viral infection who developed LA and it is proposed that respiratory viruses may play a previously unrecognized role in the aetiology of Ludwig’s angina in children.

First report of Legionella pneumophila in car cabin air filters. Are these a potential exposure pathway for professional drivers?

Recent findings have identified professional drivers as being at an increased risk of Legionnaires' disease. Our hypothesis was that used car cabin air filters represent a reservoir of Legionella bacteria, and thus a potential pathway for contamination. We analysed used cabin air filters from various types of car. The filters were analysed by culture and by molecular methods. Our findings indicated that almost a third of air filters were colonized with Legionella pneumophila. Here, we present the first finding of Legionella spp. in used car cabin air filters. Further investigations are needed in order to confirm this exposure pathway. The presence of Legionella bacteria in used cabin air filters may have been an unknown source of infection until now.

Tracking the transmission and evolution of MERS-CoV

In 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) first emerged in a patient who died of severe pneumonia in Saudi Arabia.1 Although most cases confirmed so far in the Middle East have been sporadic with an unknown source of infection, human-to-human transmission has been reported in health-care and household settings.2–4 However, the source of the virus and mode of disease transmission remain unknown despite detection of a small fragment of sequence identical to the EMC/2012 MERS-CoV in a Taphozous perforatus bat captured in Saudi Arabia5 and reports of cross-reactive antibodies to MERS-CoV in dromedary camels in Oman and the Canary Islands.

Utilidad de la procalcitonina en pacientes adultos con neoplasias hematológicas y neutropenia febril posquimioterapia. Estado del arte

Procalcitonin has proven useful to rule out meningitis in febrile children with unknown source of infection, and in the monitoring of patients with severe community-acquired pneumonia and health care-associated pneumonia including those with ventilator-associated pneumonia to guide antimicrobial therapy. In patients with fever and chemotherapy-induced neutropenia, procalcitonin has been studied to predict bacterial blood-stream infections and poor outcomes, with variable results in part because heterogeneous population included in those studies. Our aim is to describe the utility of procalcitonin in the management of adult patients with hematological malignancies and chemotherapy-induced febrile neutropenia.

Tuberkulose-Ausbruch bei 13 Personen in Sachsen-Anhalt: Hinweis auf die Infektkette durch Spoligotyping

In Germany the number of new tuberculosis incidents continues to decline slightly. Cases of illnesses are often diagnosed late, due to the uncharacteristic course of tuberculosis. The success in environment investigations by health authorities in finding incidents within one infection chain depends on the compliance of patients among other factors. Tuberculosis occurs especially in groups with social disadvantages. In this population segment the identification of contact persons of a patient with infectious tuberculosis presents difficulties. Moreover, identifying the source of infection is frequently not successful. For these reasons, additional infections and sicknesses are caused. The cultural pathogen proof, including type differentiation and resistance testing, continues to be the "gold standard" in tuberculosis diagnostics and is required for the examination of outbreaks. Molecular methods for fine typification of isolated bacterial strains and their subsequent comparison constitute an important tool in the infection epidemiology investigation of incident clustering. The objective of this work is the description of a tuberculosis infection chain in Saxony-Anhalt, which was discovered by means of a molecular biological method. The conservative method represents the environment investigations for the expedient selection of contact persons. The investigations always take 2 directions in the process. On the one hand, it is searched for the still unknown source of infection. On the other hand, persons are to be identified, who have been infected before the diagnosis became known. The diagnostics for contact persons includes besides the lung X-ray checkup exam, the Mendel Mantoux tuberculin skin test (THT), sputum tests and the Interferon Gamma (INF-γ) tests (IGRA). In described case, the molecular biological method of spoliogotyping was employed as additional instrument. Therein, fingerprint maps of the patients' tuberculosis strings were created and compared. Infection chains resulting from the environment investigations were thereby secured. We report on a tuberculosis outbreak in a district of the state of Saxony-Anhalt, which occurred in the time from June 2007 to May 2010. As result of the environment investigations, an infection chain of 13 ill patients (77% ♂, 23% ♀) was identified. In 11 cases the correlation of the infection chain was proven by spoligotyping (9 ♂, 2 ♀). 2 cases (1 ♂, 1 ♀) without verification of the pathogen cannot be attributed on basis of the epidemiological correlations.