Co-infection with Drug-Susceptible and Reactivated Latent Multidrug-Resistant Mycobacterium tuberculosis
Laura Pérez-Lago, Miguel Martínez Lirola, Yurena Navarro, Marta Herranz, María Jesús Ruiz-Serrano, Emilio Bouza, and Darío García-de-Viedma
Author affiliations: Gregorio Marañón University General Hospital, Madrid, Spain (L. Pérez-Lago, Y. Navarro, M. Herranz, M.J. Ruiz-Serrano, E. Bouza, D. García-de-Viedma); Gregorio Marañón Health Research Institute, Madrid (L. Pérez-Lago, Y. Navarro, M. Herranz, M.J. Ruiz-Serrano, E. Bouza, D. García-de-Viedma); Centro de Investigación Biomédica en Red en Enfermedades Respiratorias, Madrid (L. Pérez-Lago, Y. Navarro, M. Herranz, M.J. Ruiz-Serrano, E. Bouza, D. García-de-Viedma); Torrecárdenas Hospital, Almería, Spain (M. Martinez Lirola); Complutense University of Madrid, Spain (E. Bouza); Moncloa International Campus of Excellence, Complutense University-Politécnica University, Madrid (Y. Navarro, D. García-de-Viedma)
Figure. Identification of co-infection with drug-susceptible and reactivated latent multidrug-resistant Mycobacterium tuberculosis (MDR TB). A) Genotype of multidrug-resistant tuberculosis (MDR TB) and results for the MDR TB index patient and for 2 respiratory specimens and 1 cultured isolate from the case-patient who had a mixed MDR/susceptible infection. The same indeterminate intense-wt/faint mutant pattern test was repeated by using another 2 specimens. B) Mycobacterial interspersed repetitive units–variable number tandem repeat (MIRU-VNTR) types for the 2 strains involved in the co-infection. The results from the loci in which the analysis yielded double alleles are in bold text. Values for MIRU47 and 53 are indicated. C) Selection of 2 electropherograms representative of 2 (MIRU47 and 53) of the 12 loci with double alleles caused by mixed infection. Data that were obtained from direct analysis of a respiratory specimen or from a cultured isolate are shown.
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