台灣高雄市堪薩斯分枝桿菌之空間分析

"Spatial cluster analysis of Mycobacterium kansasii infection in Kaohsiung, Taiwan"

目標：由於堪薩斯分枝桿菌的高致病性及高雄逐年上升的發生率，本研究旨在探討高雄堪薩斯分枝桿菌感染者之空間分佈及該菌種之感染熱區範圍。方法：利用高雄市2015至2017年間堪薩斯分枝桿菌感染者之地理資訊，以最小統計區為空間單位，藉莫蘭指數分析發生率之空間分佈型態及顯著的群聚核心。並隨機抽樣門牌地址以代表空間上均質的感染分佈，再透過空間相對風險函數比較感染者與隨機感染之座標來計算感染熱區的確切範圍。結果：發生率於最小統計區下之空間自相關呈顯著正相關（呈群聚趨勢），且顯著地圖指出群聚核心位於小港區內。空間相對風險分析亦得出兩感染熱區，分別位於前金、鹽埕區的交界及小港區內部（空間相對風險落在1.54至2.27之間）。結論：高雄市堪薩斯分枝桿菌感染者的分布並非均質，且存在感染熱區。然而感染來源與易感染人群的空間分布均可能有其特定的群聚趨勢，故本研究的結果應解讀為可能影響此感染症的所有因素在空間上的綜合表現。未來仍須更多生物與環境上的證據以佐證本研究之結論。（台灣衛誌2021；40(6)：713-723）

"Objectives: Owing to the high virulence of mycobacterium kansasii and the increasing incidence in Kaohsiung, the present study aimed to analyze the spatial pattern of mycobacterium kansasii infection in Kaohsiung. Methods: We applied the Moran’s I to estimate the spatial pattern of incidence risk and to identify the cluster core. The core of the cluster was confirmed by the spatial relative risk function with contouring an infection hotspot that the location of the comparative group were randomly sampled from the address database. Results: The positive and significant spatial autocorrelation based on the incidence risk of the basic statistical area was illustrated by the significance map with the cluster core locating in Xiaogang district. The spatial relative risk function indicated two hotspots, one located across Qianjin district and Yancheng district, and the other mainly sat in Xiaogang district. All the significant spatial relative risk ranged from 1.54 to 2.27. Conclusions: Two hotspots indicated that the mycobacterium kansasii infection not homogeneously distributes in Kaohsiung City. Infection sources may have specific spatial patterns, yet the susceptible host probably has other tendencies too. Therefore, our results should be interpreted as a combination of all factors related to this infection. (Taiwan J Public Health. 2021;40(6):713-723)"