Widespread dissemination of a drug-susceptible strain of Mycobacterium tuberculosis.
In New York City, a large proportion of new tuberculosis cases has been caused by 1 drug-susceptible strain (called C strain) of Mycobacterium tuberculosis. Between 1991 and 1994, among >600 tuberculosis patients consecutively identified in four large hospitals in the city, 54 with C strain, 69 with non-C cluster pattern strains, and 42 with noncluster pattern strains were studied. Susceptibility to reactive nitrogen intermediates (RNI) of selected isolates was compared. In a case-control analysis, 51% of patients with C strain, 28% with non-C cluster strains (P < .05), and 14% with noncluster strains (P < .01) were found to be injection drug users. C strain but not 13 other unrelated isolates were resistant to RNI. Injection drug use may provide a selective pressure for an RNI-resistant tubercle bacillus to emerge, which may give the organism a biologic advantage and explain the widespread dissemination of C strain M. tuberculosis within the city.
Friedman
C R
CR
Department of Medicine, Cornell University Medical College, Bellevue Hospital Center, New York, New York, USA.
Quinn
G C
GC
Kreiswirth
B N
BN
Perlman
D C
DC
Salomon
N
N
Schluger
N
N
Lutfey
M
M
Berger
J
J
Poltoratskaia
N
N
Riley
L W
LW
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics; D009519:New York City / Q000453:epidemiology; D012091:Repetitive Sequences, Nucleic Acid; D012307:Risk Factors; D012977:Sodium Nitrite / Q000494:pharmacology*; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology
D012977:Sodium Nitrite