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Volume 6, Number 5—October 2000

Dispatch

Double infection with a Resistant and a Multidrug-Resistant Strain of Mycobacterium tuberculosis

Stefan Niemann, Elvira Richter, Sabine Rüsch-GerdesComments to Author , Max Schlaak, and Ulf Greinert
Author affiliations: Forschungszentrum Borstel, Borstel, Germany

Main Article

Table

Treatment regimens and characteristics of Mycobacterium tuberculosis isolatesa

Treatment Therapy Susceptibility testing
Months Hospital Regimen Culture Culture obtained Current resistance pattern Time delay (months)b Spoligotype
0 A/B H, R, E,c Z pos. 02/28/96 H, S 2 type I
1 B H, R, Z pos. 03/17/96 H, S 2 type I
2 B H, R, E, Z neg. - - - -
3 B H, R, E, Z neg./pos. - n.d. - n.d.
4 C H, E, Pt pos. 06/06/96 H, S, R, (E), (Rb) 2 type II
5 D R, E, Z pos. 07/12/96 H, S, R, (E), (Rb) 2 type II
6 D E, Z, Rb, Of pos. - n.d. - n.d.
7-12 D E, Z, Rb, Pt pos. - n.d. - n.d.
13 D E, Z, Rb, Pt pos. 03/15/97 H, S, R, E, Rb, Pt 1 type II
14-18 D Z, Pt, Ci pos. 04/25/97 H, S, R, E, Rb, Pt, Z 5 type II
19 D Z, Pt, Rb, Ci pos. - n.d. - n.d.
20-21 D Rb, Ci, Am, Pa pos. - n.d. - n.d.
22-24 D Rb, Ci, Am, Pa, Cl pos. - n.d. - n.d.
25-28 D Rb, Ci, Am, Pa, Cl pos./neg. 02/18/98 H, S, R, E, Rb, Pt Z, Pa 4 type II
29-32 D Rb, Ci, Am, Pa, Cl pos. 06/23/98 H, S, R, E, Rb, Pt, Z, Pa, Am 4 type II
33 D Rb, Ci, Cl, Ca pos. - n.d. - n.d.

aAbbreviations and symbols: H, isoniazid; S, streptomycin; R, rifampin; E, ethambutol; Rb, rifabutin; Pt, protionamide; Z, pyrazinamide; Pa, p=aminosalicylic acid; Am, amikacin; Of, ofloxacin, Ci, ciprofloxacin; Cl, clofazimine; Ca, capreomycin; borderline results are shown in parentheses; pos., positive culture result; neg., negative culture result; n.d., not determined.
b Time between the date on which the specimen was obtained and the date on which the drug-susceptibility pattern was available for the clinician (drug-susceptibility testings were not always performed directly after the cultures were grown but were done retrospectively).
cE was given in the first 4 days of therapy only.

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