Transmission of a multidrug-resistant Mycobacterium tuberculosis strain resembling 'strain W' among noninstitutionalized, human immunodeficiency virus-seronegative patients
Date
1999
Authors
Van Annelies R.
Warren R.M.
Beyers N.
Gie R.P.
Classen C.N.
Richardson M.
Sampson S.L.
Victor T.C.
Van Helden P.D.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Since 1990, several outbreaks of multidrug-resistant tuberculosis (MDR- TB) have been described among institutionalized patients infected with human immunodeficiency virus (HIV). We describe a community MDR-TB outbreak among HIV-seronegative patients in Cape Town, South Africa. Isolates were characterized by restriction fragment length polymorphism (RFLP) analysis and dot-blot hybridization analysis of mutations conferring resistance for isoniazid, rifampin, streptomycin, and ethambutol. All isolates were identical on RFLP analysis. In 2 patients, RFLP analysis showed exogenous reinfection during or after treatment for drug-susceptible TB. Mutation analysis confirmed the genotypic identity of the isolates. The infecting strain was genotypically related to strain W, which is responsible for the majority of MDR-TB outbreaks in New York City. Transmission of MDR-TB is thus not limited to HIV-seropositive patients in an institutional setting but occurs within a community.
Description
Keywords
ethambutol, ethionamide, isoniazid, rifampicin, streptomycin, thioacetazone, adolescent, adult, article, bacterium isolate, child, clinical article, controlled study, disease transmission, female, gene mutation, genotype, hospital infection, human, human immunodeficiency virus infection, male, multidrug resistance, mycobacterium tuberculosis, nonhuman, nucleotide sequence, priority journal, South Africa, Adolescent, Adult, Antitubercular Agents, Blotting, Southern, Child, Disease Outbreaks, Female, HIV Seronegativity, Humans, Institutionalization, Male, Microbial Sensitivity Tests, Middle Aged, Mycobacterium tuberculosis, Polymorphism, Restriction Fragment Length, South Africa, Sputum, Tuberculosis, Multidrug-Resistant
Citation
Journal of Infectious Diseases
180
5
180
5