Independent origin of mono-rifampin-resistant Mycobacterium tuberculosis in patients with AIDS.

Abstract:

:Historically, infections caused by Mycobacterium tuberculosis have been treated simultaneously with isoniazid and rifampin. As a consequence of this combined therapy, strains resistant only to rifampin were rarely recovered. However, recently there has been an increasing number of reports describing HIV-positive patients infected with mono-rifampin-resistant M. tuberculosis strains. Organisms cultured from seven patients (including six with AIDS) with infections caused by mono-rifampin-resistant M. tuberculosis, and seen at one New York City hospital, were analyzed by molecular techniques to test the hypothesis that dissemination of a single clone had occurred. IS6110 DNA fingerprinting and automated DNA sequencing of a region of the RNA polymerase beta subunit structural gene (rpoB) containing mutations that confer rifampin resistance showed that all organisms independently acquired the mono-rifampin-resistant phenotype. Molecular analysis of mono-rifampin-resistant organisms cultured from 13 additional patients in New York City confirmed independent strain origin. The data rule out the possibility of person-to-person strain transmission among these patients, and they suggest that host factors such as poor compliance with antituberculosis medications or decreased absorption of rifampin have been a driving force in the origin of these strains.

authors

Lutfey M,Della-Latta P,Kapur V,Palumbo LA,Gurner D,Stotzky G,Brudney K,Dobkin J,Moss A,Musser JM,Kreiswirth BN

doi

10.1164/ajrccm.153.2.8564140

subject

Has Abstract

pub_date

1996-02-01 00:00:00

pages

837-40

issue

2

eissn

1073-449X

issn

1535-4970

journal_volume

153

pub_type

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