Superinfection with Rifampin-Isoniazid-Streptomycin-Ethambutol (RISE)-resistant Tuberculosis in Three Patients with AIDS: Confirmation by Polymerase Chain Reaction Fingerprinting

Dl, Horn; Hewlett, Dial; Wh, Haas; Wr, Butler; Alfalla, Celia; E, Tan; Levine, Arnold J.; Nayak, Amit R.; Sm, Opal

doi:10.7326/0003-4819-121-2-199407150-00007

Cited by 31 publications

(16 citation statements)

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“…Subsequent studies, undertaking bacterial typing using bacteriophages and biovars (22)(23)(24)(25)(26), convincingly demonstrated instances of reinfection in immunocompromised patients (22,25). Further studies, using molecular fingerprint methods, confirmed reinfection, primarily in AIDS patients (4,8,11), but also in occasional patients without demonstrable immunosupressive conditions (6,(11)(12)(13)(14)(27)(28)(29)(30). The same techniques have demonstrated the occurrence of mixed initial infection (31), which, in some scenarios, would be indistinguishable from reinfection.…”

Section: Discussionmentioning

confidence: 76%

“…With the use of mycobacterial genotyping techniques it has been possible to demonstrate conclusively that exogenous reinfection can occur. Most reported instances of exogenous reinfection have involved patients infected with the human immunodeficiency virus (4,(8)(9)(10), although a few cases have been documented in persons with no identifiable immunodeficiency (11)(12)(13).…”

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confidence: 99%

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Exogenous Reinfection with Tuberculosis on a European Island with a Moderate Incidence of Disease

Caminero

Peña

Campos-Herrero

et al. 2001

Am J Respir Crit Care Med

143

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The frequency and determinants of exogenous reinfection and of endogenous reactivation of tuberculosis in patients previously treated are poorly understood. In Gran Canaria Island, Spain, between 1991 and 1996, 962 tuberculosis cases were confirmed by culture. Drug susceptibility testing was performed on available bacterial isolates and IS6110-based RFLP genotyping was carried out. Twenty-three patients (2.4%) had two positive cultures separated by at least 12 mo, 18 of whom had bacterial DNA available for genotypic analysis. The initial and final isolates from eight (44%) were different genotypes, indicating exogenous reinfection. Six of them were retreated after cure and two retreated after default. Six were HIV seronegative and two were HIV seropositive. Endogenous reactivation was seen in the remaining 10 patients of whom eight were retreated after default and two after cure. Three of the eight (38%) being retreated after default developed multidrug resistance. One genotype was responsible for a second episode of tuberculosis in five cases, three exogenous reinfections and two endogenous reactivations. In the context of a moderate incidence of tuberculosis, exogenous reinfection is an important cause of TB recurrence, even in HIV-seronegative patients.

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Section: Discussionmentioning

confidence: 76%

mentioning

confidence: 99%

Exogenous Reinfection with Tuberculosis on a European Island with a Moderate Incidence of Disease

Caminero

Peña

Campos-Herrero

et al. 2001

Am J Respir Crit Care Med

143

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“…The extent to which exogenous reinfection occurs depends on the prevalence of disease-the higher the prevalence, the greater the likelihood of exogenous reinfection (8,19). On the few occasions on which exogenous reinfection has been documented in areas with a low incidence of the disease, it has involved only selected populations, for example, alcoholic residents of a homeless shelter or patients with advanced HIV infection (3,11,16,21).…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology Study of Exogenous Reinfection in an Area with a Low Incidence of Tuberculosis

et al. 2001

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In geographical areas with a low incidence of tuberculosis, recurrent tuberculosis is generally due to reactivation of the disease. However, the relative contribution of tuberculosis reinfection increases in parallel with the incidence of disease and is likely to depend on the epidemiological context: factors such as the spread of multidrug resistance, human immunodeficiency virus (HIV) infection, and immigration from developing countries could modify disease transmission in areas at low risk for tuberculosis. A molecular epidemiology study was performed in Lombardy, Northern Italy, where the incidence of tuberculosis is 17.5 cases per 100,000 persons. A total of 2,452 cases of culture-confirmed tuberculosis in 2,127 patients were studied. A group of 32 patients (1.5%), each of whom had two episodes of tuberculosis with cure as the outcome of the first episode and with more than 6 months between the two episodes, were studied by means of restriction fragment length polymorphism DNA fingerprinting analysis. For 5 of the 32 patients (16%), the DNA fingerprinting patterns of Mycobacterium tuberculosis strains responsible for the second episode did not match those of the corresponding isolates of the first episode, indicating exogenous reinfection. Two of these patients developed multidrugresistant tuberculosis during the second episode, and in three cases the isolates belonged to clusters of M. tuberculosis strains spreading in the community. A fourfold-increased risk for reinfection was observed in immigrant patients compared to Italian subjects. In contrast, a higher risk of relapse rather than reinfection was evidenced in HIV-positive subjects and in patients infected with multidrug-resistant tuberculosis. Episodes of tuberculosis reinfection in areas with a low incidence of tuberculosis are rare compared to those in high-incidence geographical regions. In populations that have immigrated from high-risk areas, reinfection may represent a considerable contributor to the rate of recurrent tuberculosis. This finding emphasizes the importance of containing the spread of epidemic strains in close communities, in order to prevent changes in global tuberculosis trends for developed countries.

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“…In addition, exogenous reinfection should be considered as a possible reason for treatment failure or disease relapse (8)(9)(10)(11). However, an underrecognized cause of treatment failure is mixed infection with >2 strains of M. tuberculosis (12)(13)(14)(15). As reported previously (12), simultaneous infection with 2 competing strains should be considered when other common reasons are ruled out and a high index of suspicion is present.…”

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confidence: 99%

Co-infection with Pansensitive and Multidrug-Resistant Strains ofMycobacterium tuberculosis

Mendez¹,

Landon²,

McCloud³

et al. 2009

Emerg. Infect. Dis.

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Superinfection with Rifampin-Isoniazid-Streptomycin-Ethambutol (RISE)-resistant Tuberculosis in Three Patients with AIDS: Confirmation by Polymerase Chain Reaction Fingerprinting

Cited by 31 publications

References 0 publications

Exogenous Reinfection with Tuberculosis on a European Island with a Moderate Incidence of Disease

Exogenous Reinfection with Tuberculosis on a European Island with a Moderate Incidence of Disease

Molecular Epidemiology Study of Exogenous Reinfection in an Area with a Low Incidence of Tuberculosis

Co-infection with Pansensitive and Multidrug-Resistant Strains ofMycobacterium tuberculosis

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