期刊
JOURNAL OF INFECTIOUS DISEASES
卷 190, 期 1, 页码 99-106出版社
OXFORD UNIV PRESS INC
DOI: 10.1086/421501
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资金
- FIC NIH HHS [TW00231] Funding Source: Medline
- NIAID NIH HHS [R01 AI054338-04, R01 AI054338, AI22616, AI54361] Funding Source: Medline
Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem because treatment is complicated, cure rates are well below those for drug-susceptible tuberculosis ( TB), and patients may remain infectious for months or years, despite receiving the best available therapy. To gain a better understanding of MDR-TB, we characterized serial isolates recovered from 13 human immunodeficiency virus-negative patients with MDR-TB, by use of IS6110 restriction fragment-length polymorphism analysis, spacer oligonucleotide genotyping (i.e., spoligotyping), and sequencing of rpoB, katG, mabA-inhA ( including promoter), pncA, embB, rpsL, rrs, and gyrA. For all 13 patients, chronic MDR-TB was caused by a single strain of Mycobacterium tuberculosis; 8 (62%) of the 13 strains identified as the cause of MDR-TB belonged to the W-Beijing family. The sputum-derived isolates of 4 (31%) of the 13 patients had acquired additional drug-resistance mutations during the study. In these 4 patients, heterogeneous populations of bacilli with different resistance mutations, as well as mixtures of drug-susceptible and drug-resistant genotypes, were observed. This genetic heterogeneity may require treatment targeted at both drug-resistant and drug-susceptible phenotypes.
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