Transmission of a multidrug-resistant Mycobacterium tuberculosis strain resembling "strain W" among noninstitutionalized, human immunodeficiency virus-seronegative patients
Transmission of a multidrug-resistant Mycobacterium tuberculosis strain resembling "strain W" among noninstitutionalized, human immunodeficiency virus-seronegative patients
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DOI：
10.1086/315054
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发表时间：
1999-11-01
影响因子：
6.4
通讯作者：
van Helden, PD
中科院分区：
文献类型：
--
作者：
van Rie, A;Warren, RM;van Helden, PD
自1990年以来，在感染人类免疫缺陷病毒（艾滋病毒）的住院患者中发生了几次耐多药结核病（MDR-TB）的爆发。我们描述了在南非开普敦的一个社区HIV血清阴性患者中的耐多药结核病暴发。用限制性片段长度多态性（RFLP）分析和点杂交分析鉴定菌株对异烟肼、利福平、链霉素和乙胺丁醇的耐药突变。所有菌株的RFLP分析结果均一致。感染菌株在基因型上与W菌株相关，W菌株是造成纽约市大多数耐多药结核病暴发的原因。因此，耐多药结核病的传播不仅限于机构环境中的艾滋病毒血清阳性患者，而且也发生在社区内。
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.