Volume 25, Number 11—November 2019
Research Letter
Drug-Susceptible and Multidrug-Resistant Mycobacterium tuberculosis in a Single Patient
Table
Patient age, y/sex | Immune status | Site(s) of infection | Time to recurrence | Platform for strain identification | Patient country of origin | Country of diagnosis | Reference |
---|---|---|---|---|---|---|---|
24/M |
Immunocompetent |
Lymph node, gastric aspirate |
100 d |
Mixed-linker fingerprint PCR |
Nepal |
Germany |
(1) |
23/M |
HIV negative |
Pulmonary |
150 d |
Spoligotyping and MIRU |
Somalia |
USA |
(4) |
24/M |
HIV negative |
Pulmonary, gastric aspirate |
90 d |
IS6110 RFLP and spoligotyping |
Kazakhstan |
Germany |
(2) |
62/M |
HIV negative |
Pulmonary |
120 d |
MIRU-VNTR |
Portugal |
UK |
(3) |
28/M | HIV positive | Lymph node, trachea | 84 d | Spoligotyping and WGS | Philippines | USA | This study |
*IS, insertion sequence; MIRU-VNTR, mycobacterial interspersed repetitive unit–variable number tandem repeat; RFLP, restriction fragment length polymorphism; WGS, whole genome sequencing.
References
- Theisen A, Reichel C, Rüsch-Gerdes S, Haas WH, Rockstroh JK, Spengler U, et al. Mixed-strain infection with a drug-sensitive and multidrug-resistant strain of Mycobacterium tuberculosis. Lancet. 1995;345:1512–3. DOIPubMedGoogle Scholar
- Niemann S, Richter E, Rüsch-Gerdes S, Schlaak M, Greinert U. Double infection with a resistant and a multidrug-resistant strain of Mycobacterium tuberculosis. Emerg Infect Dis. 2000;6:548–51. DOIPubMedGoogle Scholar
- Hingley-Wilson SM, Casey R, Connell D, Bremang S, Evans JT, Hawkey PM, et al. Undetected multidrug-resistant tuberculosis amplified by first-line therapy in mixed infection. Emerg Infect Dis. 2013;19:1138–41. DOIPubMedGoogle Scholar
- Mendez MP, Landon ME, McCloud MK, Davidson P, Christensen PJ. Co-infection with pansensitive and multidrug-resistant strains of Mycobacterium tuberculosis. Emerg Infect Dis. 2009;15:578–80. DOIPubMedGoogle Scholar
- Yakrus MA, Driscoll J, Lentz AJ, Sikes D, Hartline D, Metchock B, et al. Concordance between molecular and phenotypic testing of Mycobacterium tuberculosis complex isolates for resistance to rifampin and isoniazid in the United States. J Clin Microbiol. 2014;52:1932–7. DOIPubMedGoogle Scholar
- Campbell PJ, Morlock GP, Sikes RD, Dalton TL, Metchock B, Starks AM, et al. Molecular detection of mutations associated with first- and second-line drug resistance compared with conventional drug susceptibility testing of Mycobacterium tuberculosis. Antimicrob Agents Chemother. 2011;55:2032–41. DOIPubMedGoogle Scholar
- Shah NS, Auld SC, Brust JCM, Mathema B, Ismail N, Moodley P, et al. Transmission of extensively drug-resistant tuberculosis in South Africa. N Engl J Med. 2017;376:243–53. DOIPubMedGoogle Scholar
- Martín A, Herranz M, Ruiz Serrano MJ, Bouza E, García de Viedma D. The clonal composition of Mycobacterium tuberculosis in clinical specimens could be modified by culture. Tuberculosis (Edinb). 2010;90:201–7. DOIPubMedGoogle Scholar
- Operario DJ, Koeppel AF, Turner SD, Bao Y, Pholwat S, Banu S, et al. Prevalence and extent of heteroresistance by next generation sequencing of multidrug-resistant tuberculosis. PLoS One. 2017;12:
e0176522 . DOIPubMedGoogle Scholar - McNerney R, Clark TG, Campino S, Rodrigues C, Dolinger D, Smith L, et al. Removing the bottleneck in whole genome sequencing of Mycobacterium tuberculosis for rapid drug resistance analysis: a call to action. Int J Infect Dis. 2017;56:130–5. DOIPubMedGoogle Scholar
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