Free Content Genotypic patterns of multiple isolates of M. tuberculosis from tuberculous HIV patients

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We investigated whether the recurrence of tuberculosis in HIV-infected patients is due to an exogenous reinfection or relapses after antituberculosis chemotherapy. We reviewed clinical information on 32 patients at a Rio de Janeiro hospital from whom multiple Mycobacterium tuberculosis isolates were taken. All isolates were analysed by DRE-PCR fingerprinting technique, and those with identical DRE-PCR patterns were analysed by the RFLP method. Twenty patients had M. tuberculosis simultaneously isolated from different organs. These patients and nine others with sequential positive cultures after 2 months of therapy showed stable DRE-PCR and RFLP patterns. One patient's isolate became resistant to isoniazid, but the molecular pattern remained unchanged despite the development of drug resistance. In three patients, the DRE-PCR patterns of the isolates changed dramatically. Clinical and microbiological evidence was consistent with active tuberculosis caused by a new strain of M. tuberculosis. The exogenous reinfection of the three patients was not due to an outbreak, but the isolates from each patient showed unique patterns.

Keywords: HIV coinfection; genotypic patterns; multiple isolates; tuberculosis

Document Type: Research Article


Affiliations: 1: Hospital Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil 2: Instituto de Desenvolvimento Tecnológico e Produtos Imunobiológicos, Fiocruz, Rio de Janeiro, Brazil 3: Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil 4: Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil

Publication date: July 1, 2000

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