Journal Article

Simultaneous Infection with Multiple Strains of <i>Mycobacterium tuberculosis</i>

Christopher R. Braden, Glenn P. Morlock, Charles L. Woodley, Kammy R. Johnson, A. Craig Colombel, M. Donald Cave, Zhenhua Yang, Sarah E. Valway, Ida M. Onorato and Jack T. Crawford

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 6, pages e42-e47
Published in print September 2001 | ISSN: 1058-4838
Published online September 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/322635
Simultaneous Infection with Multiple Strains of Mycobacterium tuberculosis

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Drug-susceptible and drug-resistant isolates of Mycobacterium tuberculosis were recovered from 2 patients, 1 with isoniazid-resistant tuberculosis (patient 1) and another with multidrug-resistant tuberculosis (patient 2). An investigation included patient interviews, record reviews, and genotyping of isolates. Both patients worked in a medical-waste processing plant. Transmission from waste was responsible for at least the multidrugresistant infection.We found no evidence that specimens were switched or that cross-contamination of cultures occurred. For patient 1, susceptible and isoniazid-resistant isolates, collected 15 days apart, had 21 and 19 restriction fragments containing IS6110, 18 of which were common to both. For patient 2, a single isolate contained both drug-susceptible and multidrug-resistant colonies, demonstrating 10 and 11 different restriction fragments, respectively. These observations indicate that simultaneous infections with multiple strains of M. tuberculosis occur in immunocompetent hosts and may be responsible for conflicting drug-susceptibilityresults, though the circumstances of infections in these cases may have been unusual.

Journal Article.  3588 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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