Abstract
Co-infection with Drug-Susceptible and Reactivated Latent Multidrug-Resistant Mycobacterium tuberculosis.
Highlights
We describe a tuberculosis (TB) case-patient with mixed infection in an area of moderate incidence
To ascertain the likelihood of 2 co-infecting strains, we analyzed the specimen and the cultured isolate by mycobacterial interspersed repetitive unit–variable number tandem repeat (MIRU-VNTR), which is highly sensitive for detecting complex infections (8,9)
Peaks in the electropherograms suggested that 1 of the 2 strains was under-represented and its proportion was lower in the cultured isolates (Figure, panel C), indicating that culturing diminished its representation of the minority strain. This finding was consistent with the inability of the GenoType test to detect the MDR strain when applied to the cultured isolate (Figure, panel A)
Summary
Co-infection with DrugSusceptible and Reactivated Latent Multidrug-Resistant Mycobacterium tuberculosis García-de-Viedma); Gregorio Marañón Health Research Institute, Madrid To the Editor: Genotyping of Mycobacterium tuberculosis (MTB) has identified mixed infections involving >1 MTB strain (1–4), which are clinically relevant when different susceptibility patterns are involved (4–7).
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