[Study on the cause of tuberculosis recurrence by Mycobacterium tuberculosis genotyping method].
OBJECTIVE
To study the contribution of exogenous reinfection to tuberculosis recurrence.


METHODS
Mycobacterium tuberculosis isolates from patients who had experienced 2 successive tuberculosis episodes during the years from January 1999 to March 2004 were genotyped by mycobacterial interspersed repetitive units (MIRU) method. The cause of tuberculosis recurrence was determined by comparing the MIRU pattern of Mycobacterium tuberculosis isolates responsible for different tuberculosis episodes from patients.


RESULTS
Of 37 qualified patients with recurrent tuberculosis, the isolates from 25 patients in their two tuberculosis episodes showed different MIRU patterns, indicating that 68% recurrent patients were due to exogenous reinfection. The exogenous reinfection rate decreased with the age from 3/3 (under 30 years) to 73% (11/15, 30 to 60 years) and 58% (11/19, over 60 years). The frequency of exogenous reinfection increased with the tuberculosis recurrent interval. Within 6 months, the exogenous reinfection accounted for 58% (7/12) of all the recurrence, while for the time more than one year, the percentage increased to 79% (11/14).


CONCLUSIONS
Exogenous reinfection was a major cause of tuberculosis recurrence in Shanghai. MIRU genotyping method is useful to study the cause of tuberculosis recurrence.
Shen
Guo-miao
GM
Key Laboratory of Medical Molecular Virology of Ministry of Education and Public Health, Shanghai Medical School, Fudan University, Shanghai 200032, China.
Xue
Zhen
Z
Shen
Xin
X
Gui
Xiao-hong
XH
Wang
Yi-feng
YF
Sun
Bin
B
Shen
Mei
M
Mei
Jian
J
Gao
Qian
Q