Transcontinental spread of multidrug-resistant Mycobacterium bovis.
Globally, the proportion of all cases of tuberculosis (TB) caused by drug-resistant strains is increasing. We report the case of a Canadian citizen who acquired a highly drug-resistant strain of Mycobacterium bovis while visiting a relative with AIDS-related tuberculosis in Spain. The origin of the strain was traced using spoligotyping, a polymerase chain reaction (PCR)-based fingerprint technology, and the European DNA database. The level of primary drug resistance-all five first-line drugs and 19 of 21 second-line drugs-in this case was unprecedented in Canada. Isolation of this strain from a Canadian citizen represents the first report of its appearance in this hemisphere. The infection was contained and combined medical-surgical treatment delivered.
Long
R
R
Departments of Medicine, Medical Microbiology, and Surgery, University of Alberta, Edmonton, Alberta, Canada.
Nobert
E
E
Chomyc
S
S
van Embden
J
J
McNamee
C
C
Duran
R R
RR
Talbot
J
J
Fanning
A
A
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000635:transmission; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002170:Canada; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D009163:Mycobacterium bovis / Q000502:physiology*; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000635:transmission*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000635:transmission*
D000900:Anti-Bacterial Agents