title: Spread of a low-fitness drug-resistant Mycobacterium tuberculosis strain in a setting of high human immunodeficiency virus prevalence.
abstract: The fitness cost associated with the evolution of resistance to rifampin in Mycobacterium tuberculosis may be different in clinical isolates compared to in vitro-generated mutants. An atypical Beijing strain (attenuated phenotype) demonstrated the ability to spread despite acquiring resistance to rifampin. Transmission was linked to human immunodeficiency virus coinfection (P = 0.029), raising concern for the spread of drug resistance in vulnerable populations.
authors.affiliation: DST/NRF Centre of Excellence for Biomedical Tuberculosis Research/ MRC Centre for Molecular and Cellular Biology, Division of Molecular Biology and Human Genetics, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.
authors.forename: O J
authors.initials: OJ
authors.lastname: Strauss
authors.forename: R M
authors.initials: RM
authors.lastname: Warren
authors.forename: A
authors.initials: A
authors.lastname: Jordaan
authors.forename: E M
authors.initials: EM
authors.lastname: Streicher
authors.forename: M
authors.initials: M
authors.lastname: Hanekom
authors.forename: A A
authors.initials: AA
authors.lastname: Falmer
authors.forename: H
authors.initials: H
authors.lastname: Albert
authors.forename: A
authors.initials: A
authors.lastname: Trollip
authors.forename: E
authors.initials: E
authors.lastname: Hoosain
authors.forename: P D
authors.initials: PD
authors.lastname: van Helden
authors.forename: T C
authors.initials: TC
authors.lastname: Victor
mesh_terms: D000904:Antibiotics, Antitubercular / Q000494:pharmacology*; D003062:Codon / Q000235:genetics; D024881:Drug Resistance, Bacterial; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1; D006801:Humans; D008826:Microbial Sensitivity Tests; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D020641:Polymorphism, Single Nucleotide; D015995:Prevalence; D012293:Rifampin / Q000494:pharmacology*; D013019:South Africa / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*
chemical_list: D000904:Antibiotics, Antitubercular; D003062:Codon; D012293:Rifampin