Genotypic patterns of multiple isolates of M. tuberculosis from tuberculous HIV patients.
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.
Lourenço
M C
MC
Hospital Evandro Chagas, Fiocruz, Rio de Janeiro, Brazil.
Grinsztejn
B
B
Fandinho-Montes
F C
FC
da Silva
M G
MG
Saad
M H
MH
Fonseca
L S
LS
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000382:microbiology*; D000328:Adult; D016172:DNA Fingerprinting; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods; D012150:Polymorphism, Restriction Fragment Length; D012008:Recurrence; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000382:microbiology*