Effect of mixed strain infections on clinical and epidemiological features of tuberculosis in Florida

Mixed tuberculosis infections in Northwest of Iran

“…Similar to our study mixed infection was 3.1 % in Inner Mongolia, China, and Vietnam [22,23]. However, mixed infection was lower than our study in Guyana and Suriname (0.6%), Botswana (1.7%), Sichuan province, China (2.4%), and Florida, USA (2.6%) [12,14,24,25]. Mixed infection in Kampala, Uganda (7.1%), South Africa (9%), Georgia (13.1%), the capital of Iran (26.6%), and Tehran province, Iran (53%) was higher than in our study [5,11,[26][27][28].…”

“…Treatment failure in TB patients is caused by a variety of factors, including incomplete drug administration, irregular drug use, premature drug discontinuation, drug resistance, and mixed in- fection, particularly when the patient is infected with a mix of resistant and sensitive microorganisms and drug resistance is not correctly diagnosed. Antibiotic treatment pressure can alter the dominant strains in sputum culture, resulting in treatment failure and increased mortality in patients with mixed infections, thus patients should be given extra care [6,25,32]. Furthermore, as mixed infections accelerate the propagation of drug-resistant strains, drug susceptibility testing on various colonies is essential in mixed infections [6,27].…”

“…In detecting mixed infections, the quality of sputum, testing on sputum samples, culture medium, minimum number of cultures, molecular typing method and infection status can be effective [33]. Acquisition of mixed infections depends on the incidence of infection in the community and the diversity of its strains found in the environment and population, but it can occur in places where the prevalence of tuberculosis is low [23,25]. In jails and regions where HIV is more prevalent, mixed infection is widespread [11,26].…”

“…In jails and regions where HIV is more prevalent, mixed infection is widespread [11,26]. Local TB frequency, past tuberculosis treatment history, long-term hospitalization, aging, congenital immunodeficiency, and immunosuppressive conditions including alcoholism, malnutrition, renal failure, cancer, children suffering from rheumatoid arthritis, leukemia and diabetes can all raise the likelihood of mixed infection [25,28,[34][35][36]. To lessen the amount of instances of mixed infection, it is important to treat latent TB infections and halt transmission, which may be accomplished by speeding up access to high-risk individuals such as HIV-positive people and identifying suspects [24].…”

Genetic Stability ofMycobacterium smegmatisunder the Stress of First-Line Antitubercular Agents: Assessing Mutagenic Potential

“…It is now commonly accepted that the M. tuberculosis population within individual TB patients can be more heterogeneous than was traditionally thought (16,17). The coexistence of both drug-resistant and drug-sensitive strains in a single patient, or even several drug-resistant strains with discrete drug resistance-conferring mutations has been described in clinical isolates (18)(19)(20). Warren et al found that the occurrence of mixed infections reached 19 % of the examined patients in South Africa by using a PCR-based strain classification method (21).…”