Acquired drug resistance in Mycobacterium tuberculosis isolates recovered from compliant patients with human immunodeficiency virus-associated tuberculosis.
We describe five compliant patients with human immunodeficiency virus (HIV)-associated tuberculosis (TB) that relapsed, with acquisition of resistance by the original Mycobacterium tuberculosis strains. Both the first and second isolates from each patient had the same IS (insertion sequence) 6110-based DNA fingerprint patterns. Three of the five patients developed TB that was resistant to rifampin alone; no mutation in the region of the rpoB gene was detected by a line probe assay in two of the isolates from these patients. We discuss several factors presumably associated with acquired drug resistance in HIV-infected patients, including exogenous reinfection, drug interactions, malabsorption of drugs, and the presence of a large organism burden.
March
F
F
Servei de Microbiologia, Hospital Santa Creu i Sant Pau, and the Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Spain.
Garriga
X
X
Rodríguez
P
P
Moreno
C
C
Garrigó
M
M
Coll
P
P
Prats
G
G
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000382:microbiology*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004269:DNA, Bacterial / Q000032:analysis; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D004352:Drug Resistance, Microbial; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D010349:Patient Compliance; D012293:Rifampin / Q000627:therapeutic use*; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*
D000995:Antitubercular Agents; D004269:DNA, Bacterial; D012321:DNA-Directed RNA Polymerases; C105078:RNA polymerase beta subunit; D007538:Isoniazid; D012293:Rifampin